• 동의신경정신과학회지
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• 제24권3호
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• pp.257-262
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• 2013

Objectives : Aripiprazole is unique drug among the SGA (Second generation antipsychotics) in its pharmacology and pharmacokinetics,but is similar in clinical efficacy. Aripiprazole acts as a partial agonist at dopamine D2 receptors, activating the receptor but eliciting a reduced response compared to the natural neurotransmitter. There are some side effects of aripiprazole, the most common side effects of aripiprazole are headache, nausea, vomiting, insomnia, tremor, constipation and EPS. Difficulty in opening eyes is not defined EPS yet, but it is a rare but important side-effect symptom of aripiprazole. Methods : This article is about a case of side-effect symptom of aripiprazole, 26-year-old single female suffering from schizophrenia had difficulty in opening eyes while she was taking antipsychotics. During the hospitalization, the relaxation therapy is helpful not only to reduce tension in the eyelids but also to headache. Results : It is important that early recognition of aripiprazole-induced oculogyric dystonia can prevent life-threatening complications. Education medical staff to this easily treatable reaction will improve overall quality of health care. Conclusions : This case notifies the need for awareness of the risk of acute oculogyric dystonia in adolescent female patients receiving aripiprazole.

• 정신신체의학
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• 제25권2호
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• pp.120-128
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• 2017

연구목적 섬망의 증상을 조절하기위해 일반적으로 항정신병약물이 사용되지만, 투약 기간 및 용법과 같은 처방 양상과 환자의 임상 경과 사이의 연관성에 대한 연구는 아직 부족한 상태이다. 이 연구를 통해 섬망을 경험한 환자에서 항정신병약물의 처방 양상에 따라 임상 경과에 차이가 있는지 확인하고자 하였다. 방 법 서울의 일 종합병원에서 섬망으로 자문조정이 의뢰된 입원 환자 중 2016년 7월부터 2017년 2월까지 퇴원한 212명을 대상으로 하였다. 환자의 전자의무기록을 후향적으로 검토하여 입원 기간, 사망, 인구통계학적 자료 및 임상적 요인을 조사하였고, CAM-ICU를 통해 섬망 지속 기간을 측정하였다. 항정신병약물의 처방 유형에 따라 지속투약군, 최적투약군, 필요투약군으로 나누어 임상 경과를 비교하였다. 결 과 항정신병약물을 섬망 회복 후에도 지속적으로 투약 받은 지속투약군은 섬망 증상이 있는 기간에만 투약 받은 최적투약에 비하여 입원 기간 및 섬망 이환기간에 유의한 차이가 없었으며, 퇴원시 불필요한 항정신병약물 처방을 받은 비율이 높았다. 섬망 이환기간에 비해 짧은 기간 항정신병약물을 사용한 필요투약군은 다른 두 군에 비해 섬망 이환기간이 길고 사망률이 높았다. 결 론 이 연구의 결과는 섬망 이환기간에만 항정신병약물을 투여하는 것이 적절함을 시사한다. 또한 섬망이 회복된 후에 불필요하게 항정신병약물이 처방되는 것을 최소화하기위한 정신건강의학과 자문의의 적극적인 개입이 필요하겠다.

• 생물정신의학
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• 제22권4호
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• pp.155-162
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• 2015

Objectives Second-generation antipsychotics (SGAs) are frequently used in the treatment of bipolar disorder. However, there is still no consensus on their risk of tardive movement syndromes especially for first-generation antipsychotics (FGAs)-naïve patients. This study aimed to investigate the prevalence and associated factors of SGAs-related tardive dyskinesia and tardive dystonia in patients with bipolar disorder, in a naturalistic out-patient clinical setting. Methods The authors assessed 78 non-elderly patients with bipolar (n = 71) or schizoaffective disorder (n = 7) who received SGAs with a combined use of mood stabilizers for more than three months without previous exposure to FGAs. Multiple direct assessments were performed and hospital records longer than one recent year describing any observed tardive movement symptoms were also reviewed. Results The prevalence rates of tardive dyskinesia and tardive dystonia were 7.7% and 6.4%, respectively. These patients were being treated with ziprasidone, risperidone, olanzapine, quetiapine, or paliperidone at the time of the onset of the movement symptoms. Tardive dyskinesia was mostly observed in the orolingual area, and tardive dystonia was most frequently detected in oromandibular area. A past history of acute dystonia was significantly associated with presence of both tardive movement syndromes. Conclusions Our findings suggest that SGAs-related tardive movement syndromes occur in a substantial portion of bipolar disorder patients. Acute dystonia, a reported risk factor of tardive movement syndromes in the era of FGAs is confirmed as a risk factor of both tardive dyskinesia and tardive dystonia that were induced-by SGAs.

• 정신신체의학
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• 제30권2호
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• pp.112-118
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• 2022

연구목적 졸피뎀은 세계적으로 불면증에서 널리 쓰이고 있는 약물이다. 그러나 졸피뎀을 복용한 환자에게서 중추 신경계 부작용이나 수면 연관 행동을 보인다는 여러 보고가 있다. 본 연구는 입원 환자를 대상으로 졸피뎀 복용 후 나타나는 수면 연관 행동에 영향을 미치는 위험요인을 조사하기 위해 시행되었다. 방 법 2019년 1월 1일부터 2019년 12월 31일까지 인하대학교 병원에 입원한 졸피뎀을 복용한 환자들의 의무기록을 후향적으로 검토하였다. 졸피뎀 사용 후 나타나는 수면 연관 행동의 유무, 나이, 성별, 기저 질환, 투약력, 졸피뎀의 용량, 졸피뎀의 종류를 조사하였다. 결 과 졸피뎀을 복용한 907명의 환자 중 수면 연관 행동을 보인 환자는 102명(11.2%)이고, 65세 이상(OR 2.681, 95% CI 1.677-4.287, p<0.001), 남성(OR 1.556, 95% CI 1.007-2.404, p=0.046), 항정신병제 복용(OR 3.305, 95% CI 1.577-6.925, p=0.002), 항정신병제와 벤조디아제핀 동시 복용(OR 3.792, 95% CI 1.677-8.572, p=0.001)한 경우 수면 연관 행동이 발생할 확률이 유의하게 높았다. 결 론 졸피뎀 사용 후 생기는 수면 연관 행동의 위험 요소는 성별, 고령, 항정신병제 병용 투약, 항정신병제와 벤조디아제핀 동시 병용 투약 여부로 추정된다.

• 대한약학회:학술대회논문집
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• 대한약학회 2005년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.1
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• pp.131-132
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• 2005

• The Korean Journal of Pain
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• 제32권1호
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• pp.1-2
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• 2019

• 생물정신의학
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• 제3권1호
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• pp.22-29
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• 1996

The introduction of chlorpromazine in the 1950's revolutionized the treatment of schizophrenia and ultimately led to the development of selective $D_2$ antagonists such as haloperidol, a goal in keeping with the prevalent theories at that time. However, limitations in the efficacy of these agents, a growing awareness of their side effects, and theoretical shifts in our understanding of schizophrenia have encouraged ongoing efforts to develop better 'atypical' antipsychotics. Clozapine, and subsequently risperidone, represent examples of these novel compounds, both of which incorporate shared serotonin-dopamine antagonism(SDA). The next years will be dominated by further development of SDA compounds, although a number of other lines of investigation are also being pursued.

• 비만대사연구학술지
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• 제1권1호
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• pp.39-42
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• 2022

Obesity is a chronic disease associated with severe complications. A major complication of obesity is depression, which can worsen obesity and vice versa. In addition, most antidepressants or antipsychotics cause weight gain, and the relationship between obesity and depression is clinically critical. However, treatment of obese patients with major depressive disorder is complicated. Bariatric physicians should provide appropriate behavioral interventions alongside pharmacological treatment, considering psychiatric symptoms, drug side effects, and drug interactions. Two successful cases of moderate-to-severe obese patients with major depressive disorder who had been treated for obesity using behavioral intervention therapy along with liraglutide will be discussed. This report highlights the safety and efficacy of liraglutide treatment of obesity in patients with depression who take antidepressants and antipsychotics.

• 신경정신의학
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• 제57권4호
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• pp.287-300
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• 2018

Of the different phases of bipolar disorder, bipolar depression is more prevailing and is more difficult to treat. However, there is a deficit in systemic research on the pharmacological treatment of acute bipolar depression. Therefore, consensuses on the pharmacological treatment strategies of acute bipolar depression has yet to be made. Currently, there are only three drugs approved by the Food and Drug Administration for acute bipolar depression : quetiapine, olanzapine-fluoxetine complex, and lurasidone. In clinical practice, other drugs such as mood stabilizers (lamotrigine, lithium, valproate) and/or the other atypical antipsychotics (aripiprazole, risperidone, ziprasidone) are frequently prescribed. There remains controversy on the use of antidepressants in bipolar depression. Here, we summarized the evidence of current pharmacological treatment options and reviewed treatment guidelines of acute bipolar depression from recently published studies.

• 생물정신의학
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• 제3권2호
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• pp.251-257
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• 1996

Selective serotonin reuptake inhibitors(SSRIs), as haloperidol, ore metabolized in the cytochrome P450IID6. They can cause inhibition of metabolism of antipsychotics to elevate the serum level of antipsychotics and exacerbate the extrapyramidal symptoms when co-administered with antipsychotics. Among these SSRIs, there ore a few studies about paroxetine compared to fluoxetine or sertraline. In this study, we have intended to know the drug interaction of paroxetine and haloperidol when co-administered two drugs for the chronic schizophrenics by assessing the changes of positive, negative symptoms and extrapyramidal symptoms. for this purpose, we selected 29 subjects, the chronic schizophrenics with no physical problems. They were under maintenance therapy of haloperidol. They ore randomly assigned to placebo group(n=12) and drug group(n=17) by using double blind method. And then, placebo or paroxetine 20mg were administered to the subjects of each groups during 8 week period. We have assessed their psychopathology and extrapyramidal symptoms using Positive and Negative Syndrome Scale(PANSS), Hamilton Rating Scale lor Depression(HRSD), Simpson-Angus Scale at 0, 2, 4, 6, 8 weeks and serum haloperidol, reduced haloperidol levels at 0, 4, 8 weeks during the period. The results ore analysed by using repeated measure MANOVA. 27 subjects have completed the study during 8 weeks. among the subjects, 1) PANSS, HRSD ; no significant difference between groups. 2) Simpson-Angus Scale ; no significant change according to the time and no significant difference between the groups(no group and time effect). 3) Haloperidol and reduced haloperidol level ; no significant change. When co-administered paroxetine and haloperidol, there ore no significant changes of the psychopothology and no significant changes of the extrapyramidal symptoms. In this result, paroxetine seems to be not to affect the metabolism of haloperidol.