• Anxiety and mood
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• v.14 no.2
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• pp.53-62
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• 2018

Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea. Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval. Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.

• Bulletin of the Korean Chemical Society
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• v.33 no.8
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• pp.2597-2602
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• 2012

Novel 1,4-substituted piperazine derivatives 5, Series A and B were designed by fragment analysis and molecular modification of 4 selected piperazine-containing compounds which possess antidepressant activity. We synthesized new 39 analogues of Series A and 10 compounds of Series B, respectively. The antidepressant screening against DA, NE, and serotonin neurotransmitter uptake inhibition was carried out using the Neurotransmitter Transporter Uptake Assay Kit. The compounds in Series B showed relatively higher reuptake inhibitory activity for SERT, NET, and DAT than those in Series A. The length of spacer between the central piperazine core and the terminal phenyl ring substituted at the piperazine ring in Series B seems to exert an important role in the activity.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.45-48
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• 2008

A 57-year-old man was transferred to our emergency department with decreased mental status after organophosphate intoxication. He had a four year history of benzodiazepine and hypnotic medication use for chronic insomnia and a depressive mood disorder. He had no previous history of seizures, diabetes mellitus, and hypertension. By hospital day 5, the patient was noted to be awake and to have repetitive jerking movements involving the left upper extremity, and appeared apathetic, depressed and less responsive to external stimuli. A benzodiazepine withdrawal syndrome was subsequently apparent when he developed several generalized tonic clonic seizures and status epilepticus. Using a continuous midazolam intravenous infusion, we successfully controlled the refractory seizure without complications. We present a rare case of status epilepticus from a benzodiazepine withdrawal that developed during the treatment for organophosphate intoxication.

• Korean Journal of Biological Psychiatry
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• v.1 no.1
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• pp.17-30
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• 1994

Several different classes of antidepressants(ADs) with newer drugs becoming available have been used for the phamacological management of a broad spectrum of mental disorders, among which depressive disorder is most commonly indicated. Successful clinical use of ADs requires a complete understanding of the psychopharmacological properties of ADs and on accurate knowledge of patients, characteristics based on clinical experience and theoretical framework. This paper aims at providing some practical information on the clinical use of ADs to assist clinicians in treating patients with major depression. The author describes (1) different classes of ADs and their presumed mechanisms of action, (2) clinical characteristics of ADs focusing on side-effect profiles, (3) some issues arising during the treatment course such as : a) pretreatment tasks, b) choice of ADs, c) therapeutic drug dose and monitoring of drug concentration, d) three stages of treatment and e) strategies in refractory depression and (4) ADs in special patient groups.

• Journal of Preventive Medicine and Public Health
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• v.50 no.4
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• pp.262-267
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• 2017

Objectives: The US ranks ninth in obesity in the world, and approximately 7% of US adults experience major depressive disorder. Social isolation due to the stigma attached to obesity might trigger depression. Methods: This paper examined the impact of obesity on depression. To overcome the endogeneity problem, we constructed pseudopanel data using the Behavioral Risk Factor Surveillance System from 1997 to 2008. Results: The results were robust, and body mass index (BMI) was found to have a positive effect on depression days and the percentage of depressed individuals in the population. Conclusions: We attempted to overcome the endogeneity problem by using a pseudo-panel approach and found that increases in the BMI increased depression days (or being depressed) to a statistically significant extent, with a large effect size.

• Korean Journal of Biological Psychiatry
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• v.23 no.1
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• pp.1-11
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• 2016

Development of various antidepressants such as monoamine oxidase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressant has led to a tremendous progression of pharmaceutical treatment for depression, but still there are some limitations of current antidepressants, such as treatment-resistant depression and delayed onset of antidepressants. The pathogenesis of depression is unclear because depression is a heterogeneous disease state, and the mechanisms of antidepressants remain uncertain as well. Nevertheless, in an attempt to develop novel antidepressants, some trials have been conducted based on the potential biological mechanism discovered in the numerous research results. This review will provide information about the potential novel antidepressants and the current states of clinical studies using them. In particular, some potential novel antidepressants anti-inflammatory agents, antioxidants, anticholinergics, modulators of Hypothalamic Pituitary Adrenal Axis, glutamate, and opioid systems, as well as some neuropeptides such as susbstance P, neuropeptide Y, and galanin will be discussed.

• Archives of Obesity and Metabolism
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• v.1 no.2
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• pp.83-88
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• 2022

Obesity increases the risk of developing metabolic diseases such as hypertension, type 2 diabetes, hyperlipidemia, and cardiovascular diseases, as well as some cancers. To prevent the occurrence of these diseases and death, it is essential to manage obesity. Though there are several treatments for obesity, lifestyle interventions, such as diet and exercise, and drug therapy are most widely used in clinical practice. Among the anti-obesity drugs available, the weight loss effect of naltrexone/bupropion has been well-proven. We present a case study in which naltrexone/bupropion, a glucagon-like peptide-1 agonist, and a sodium-glucose transporter 2 inhibitor showed significant weight loss and improved metabolic parameters. Additionally, the management of type 2 diabetes and hypertension, which are common diseases in patients with obesity, was also included.

• Communications for Statistical Applications and Methods
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• v.31 no.1
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• pp.87-104
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• 2024

Most functional magnetic resonance imaging (fMRI) studies in resting state have assumed that the functional connectivity (FC) between time series from distinct brain regions is constant. However, increased interest has recently been in quantifying possible dynamic changes in FC during fMRI experiments. FC study may provide insight into the fundamental workings of brain networks to brain activity. In this work, we focus on the specific problem of estimating the dynamic behavior of pairwise correlations between time courses extracted from two different brain regions. We compare the sliding-window techniques such as moving average (MA) and exponentially weighted moving average (EWMA), dynamic causality with vector autoregressive (VAR) model, dynamic conditional correlation (DCC) based on volatility, and the proposed alternative methods to use differencing and recursive residuals. We investigate the properties of those techniques in a series of simulation studies. We also provide an application with major depressive disorder (MDD) patient fMRI data to demonstrate studying dynamic correlations.

• Korean Journal of Biological Psychiatry
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• v.13 no.3
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• pp.162-169
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• 2006

Objective : Since some studies have shown that the brain-derived neurotrophic factor(BDNF) has an important role in the pathophysiology of depression, this study investigated the relationship between BDNF genetic polymorphism and the long-term outcome of the antidepressant treatment. Method : One hundred and eight patients with major depressive disorder were evaluated for the long-term outcome(up to 3 years) of antidepressant treatment. The severity and improvement of depression were assessed with the Clinical Global Impression(CGI) Scale. The genotypes of BDNF 196A/G polymorphism in the patients were determined using Restriction Fragment Length Polymorphism(RFLP). Result : The genotypes of 128 patients were investigated and 95 patients of those have been evaluated for 3 years. No significant differences were noted comparing three-genotype groups for CGI scales at baseline, 4 weeks, 8 weeks, 1 year, 2 years and 3 years. Conclusion : This result shows that BDNF polymorphism investigated in this study was not associated with the long-term outcome of the antidepressant treatment. However, further studies with another BDNF polymorphism should be needed.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.173-180
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• 2005

Purpose:We investigated the effect of menopausal duration on cognitive function using adjunctive hormone replacement therapy(HRT) in postmenopausal women with depression. Method:Twelve postmenopausal women with depressive disorder were enrolled. Six patients having menopausal duration of less than 3 years was assigned to the short duration group and six patients of more than 3 years to the long duration group. Each patient was treated with conjugated equine estrogen(1.25mg) plus medroxyprogesterone(5mg) for 8 weeks. Cognitive performance was measured by the Verbal Memory Test, Visual Memory Test, Trail Making Test, Digit Symbol Test, and Attention Shift Test. The Beck Depression Inventory was used for evaluation of depressed mood. The reproductive hormone levels were also measured. Results:The long duration group showed the lower performance only in Trail Making Test B compared with the short duration group at baseline. After 8 weeks, the long duration group performed significantly better in the Trail Making Test B compared with the short duration group. The differences in change of depressive mood and gonadal hormone level between two groups were not significant. Conclusion:Menopausal duration before HRT may influence the effect of estrogen on cognition in some cognitive domains. This might be related with estrogen receptor hypersensitivity which induced by the longer estrogen deficiency.