• 제목/요약/키워드: psychotropic

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Characterization of in vitro Metabolites of Methylenedioxy Designer Drugs

  • Jun Sang Yu;So Young Jo;Il-Ho Park;Hye Hyun Yoo
    • Mass Spectrometry Letters
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    • 제14권1호
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    • pp.1-8
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    • 2023
  • Eutylone, dibutylone, and dimethylone are potential psychotropic designer drugs. The purpose of this study was to investigate the in vitro metabolic pathways of synthetic cathinones with methylenedioxy groups. The three methylenedioxy derivatives were incubated with human liver microsomes. The metabolites were characterized based on liquid chromatography and quadrupole-time-of-flight mass spectrometry. Eutylone, dibutylone, and dimethylone were metabolized to yield three, six, and four metabolites, respectively. Reduction and demethylenation were the major metabolic pathways for all three drugs tested. However, dibutylone and dimethylone showed an additional metabolite generated via N-oxidation. These results provide evidence for the in vivo metabolism of methylenedioxy synthetic cathinones, and could be applied to the analysis of synthetic cathinones and their relevant metabolites in biological samples.

일 병원 정신건강의학과로 자문의뢰 된 HIV 감염/후천성면역결핍증 환자의 임상적 특성과 향정신약물 사용 (Clinical Characteristics and Use of Psychotropic Agents among HIV-Infected/AIDS Patients Referred for Psychiatric Consultation)

  • 신상호;김현정;유소영;신형식;원성두;이소희
    • 정신신체의학
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    • 제22권1호
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    • pp.31-39
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    • 2014
  • 연구목적 이 연구는 2년 6개월 동안 일 병원에 입원 중인 HIV감염/AIDS환자에 대한 정신건강의학과 자문 의뢰를 분석하였다. 방법 일 병원에서 2011년 1월 1일부터 2013년 6월 30일까지 자문 의뢰된 97명의 HIV감염/AIDS 환자와 282개의 자문 의뢰를 대상으로 후향적 의무기록 연구를 수행하였다. 결과 97명의 HIV감염/AIDS 환자 중 91명(93.8%)이 남자였으며, 평균연령은 48세, 연구 기간 동안 평균 1인당 자문건수는 2.8건이었다. 주로 호소한 증상으로는 우울 102건(55.3%), 불면 60건(14.0%), 불안감 31건(7.2%) 등이었으며, 최초 자문의뢰 시 진단된 정신과적 질환은 우울장애 37명(37.0%), 인지장애 11명(11.0%), 섬망 9명(9.0%) 등 이었고 투약 권고된 향정신병 약물은 Lorazepam 99건(17.2%), Escitalopram 90건(15.7%), Quetiapine 84건(14.6%) 순이었다. 결론 HIV감염/AIDS 입원 환자들은 '우울감', '불면', '자살사고/시도' 등을 주문제로 정신건강의학과로 자문의뢰 되었고, 자문의뢰 환자의 85명(93.3%)에서 정신장애로 진단을 받았다 그러나 자문의뢰 환자의 16.9%만 퇴원 후 본원 정신건강의학과로 외래 추적 진료가 이루어져, 향후, 정신건강문제가 HIV감염 및 AIDS의 치료 순응도, 예후, 전파에 미치는 영향에 대한 장기적 연구가 필요할 것으로 보인다.

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기분장애에서 risperidone의 양면성 (Risperidone as a Janus in Mood Disorder)

  • 윤도준
    • 생물정신의학
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    • 제4권2호
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    • pp.198-210
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    • 1997
  • To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

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여성 정신분열병 환자의 항정신성 약물 복용 체험 (The Lived Experience of the Women with Schizophrenia Taking Antipsychotic Medication)

  • 송은주
    • 대한간호학회지
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    • 제41권3호
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    • pp.382-392
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    • 2011
  • Purpose: This study was done to identify some natural meaning through the dosage experience of psychoactive drugs in women patients with schizophrenia. Methods: The Hermeneutic phenomenology written by van Manen was used. The period for data collection was from November 2009 to January 2010. This study took place in mental health hospitals and mental health centers in two cities in North Jeolla Province. Nine patients with schizophrenia participated. Data collection was done through individual in-depth interview. Results: The seven natural subjects demonstrated by participants from this study were 'Pills forcibly taken like veiled threats', 'A terrible side effect, a side effect rooted slowly', 'Shame which cannot be hidden as a woman', 'A bad medicine took away from motherhood', 'The fate of a wife who can't be equal', 'A struggle for the complete recovery without promise', and 'Participants want the future without medicine'. Conclusion: The results of this study indicate that the urgent need to develop a safe and believable psychoactive drug for woman patients considering the time of menstruation, pregnancy, childbirth, and child raising.

신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로 (Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry)

  • 류성곤;권희정
    • 정신신체의학
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    • 제16권1호
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    • pp.25-30
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    • 2008
  • 최근 노인인구의 급속한 증가로 인하여 정신과에서 노인에 대한 자문의 중요성이 확대되고 있다. 따라서 임상에서의 노인에 대한 정신과 자문의 특징과 지침에 대한 이해가 필요하다. 타과적 질환을 갖는 노인에 대한 정신과적 자문은 다른 연령층과는 다른 특성을 갖는다. 노화에 따른 장기 기능의 변화와 약동학 및 약력학의 변화에 대한 숙지가 노인에 대한 정신약물학적 접근에 매우 필수적이다. 타 연령층에 비해 노인에 대한 정신과적 자문은 상대적으로 적은 것으로 조사되었으나 실제 정신과적 자문이 노인질환의 재원기간이나 기타 사망률 등을 낮출 수 있음을 고려할 때, 노인에 대한 자문을 저해하는 요인들을 분석하고 교정하는 것이 매우 필요하다.

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향정신성약물(向精神性藥物)이 뇌(腦) amine 함량(含量) 변동(變動)에 미치는 영향(影響)(제 1 보고)(第 1 報告) (Influences of the Psychotropic Drugs on the Brain Amine Concentration (Part 1))

  • 이세규;김혜성
    • 대한약리학회지
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    • 제6권1호
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    • pp.15-22
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    • 1970
  • The present study is concerned with the demonstration of the relationship between the behavior and the brain concentration of noradrenaline resulted from pretreatment of amphetamine in isolated or aggregated rats. The experimental subjects were rats weighing from 120g to 200g housed 1, 2, and 6 in a cage. Analeptic activity of amphetamine was measured by determining the sleeping time induced by pentobarbital sod. The noradrenaline content in brain was determined with Aminco-Bowmann's spectro-photofluorometer by Lee's modification of Shore and Olin method. Results: 1) The analeptic activity of amphetamine on the sleeping time induced by pentobarbital sod. was more increased in the grouped rats than in isolated animal. 2) In being isolated and grouped rats, the sleeping time induced pentobarital sod, was markedly prolonged by pretreatment of amphetamine. 3) Means of housing rats, e.g., isolation or aggregation did not seem to affect the brain noradrenaline depleting action. 4) Repeated daily parenteral administration of amphetamine sulfate for a period 1 to 3 weeks resulted in decrement of brain noradrenaline concentration in being isolated and grouped rats. 5) The prolongation of sleeping time of the isolated or aggregated rats, when pretreated with amphetamine, compared with that of stock rats, seems to be attributable rather to the means of housing than the variation of the noradrenaline caused by amphetamine.

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우울증 치료에서의 어려운 문제들 (Difficult Clinical Problems of Treatment in Depression)

  • 민경준
    • 생물정신의학
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    • 제8권1호
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    • pp.37-46
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    • 2001
  • Whenever a clinician manages the patients with depression, he may meet various problems that make it difficult to treat them. Even though he has good skills and knowledge about depression, some barriers will be appear during his practice. In general, the difficulties in treating depression are treatment-resistance, adverse effects of antidepressants, pregnancy in female patients, comorbid medical conditions, poor compliance, drug-drug interactions, and so on, which are related with pharmacological treatments. Here, only the two of them, the treatment-resistant depression and difficult problems concerned with pregnancy, were discussed. Some level of treatment resistance is the norm rather than the exception. As the treatment failure stems from inadequate treatment, it is important that the clinician should prescribe medications with sufficient doseage and adequate duration. And to overcome the treatment resistant depression the polypharmacy is necessary, in that case, the side effects and toxicities should be explored and managed immediately. So the clinician have to learn more about the pharmacokinetic and pharmacodynamic mechanisms of each drugs used in treatment of depression. When the risk of the fetus by the exposure is higher than the risk of untreated maternal psychiatric disorder, psychotropic medications should be used during pregnancy. Women who are maintained on psychotropics and become pregnant, as well as women with the new onset of psychiatric symptoms during pregnancy, should be carefully reassessed. However, data concerning the potential risk of long-term behavioral changes following prenatal exposure to psychotropics is rare, so further longitudinal follow-up studies are needed.

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호흡기 질환의 신경정신과적 측면 (Neuropsychiatric Aspects of Pulmonary Disease)

  • 남범우
    • 정신신체의학
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    • 제17권2호
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    • pp.45-51
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    • 2009
  • 호흡기 질환은 전 세계에 걸쳐 수백만 명의 사람에게 영향을 준다. 많은 연구에서 호흡기 질환과 정신 질환의 관련성을 보고하고 있음에도 불구하고 호흡기 질환을 가진 환자의 정신과적 질환과 증상의 치료에 대한 자료 및 호흡기약물과 정신약물간의 상호작용에 대한 지식은 매우 부족하다. 이 논문에서는 1) 의사들이 임상에서 흔히 볼 수 있는 천식, 만성폐쇄성폐질환, 과호흡, 결핵, 폐암과 같은 주요 호흡기 질환의 신경정신과적 측면 2) 폐 질환 환자에서의 불안, 우울, 정신병적 증상과 같은 정신과적 증상의 치료 3) 정신약물이 호흡기에 미치는 영향과 호흡기 약물과의 상호 작용을 고찰하였다.

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정신 신체의학에서 최신 치료 약물 (Drug Treatment in Psychosomatic Disease)

  • 송지영
    • 정신신체의학
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    • 제9권2호
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    • pp.133-142
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    • 2001
  • 정신 신체 장애 환자를 치료하는데 있어서는 우선 광범위한 정신선체 장애에서 이용되는 향정신 약물 뿐만이 아니라 관련 내과 치료 약물에 대한 기본적인 지식과 활용책이 요망(要望)된다. 그리고 다양한 종류의 치료 약물과 치료 방법은 환자의 질병관, 질병행동에 의거하여 변형될 수 있어야 한다. 최근에 소위 대체치료에서 활용되는 한약제, 생약제제, 향기 치료 등에 대해서, 적어도 이것이 결정적인 부작용이 없다면 의사가 적극적으로 활용(活用)하는 자세가 바람직하다. 그리고 약물 작용 등의 과학적인 기전과 효험도는 의사의 주도(主導) 하에 연구해 나가야 할 것이다.

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Health Effects of Small Volatile Compounds from East Asian Medicinal Mushrooms

  • Pennerman, Kayla K.;Yin, Guohua;Bennett, Joan Wennstrom
    • Mycobiology
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    • 제43권1호
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    • pp.9-13
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    • 2015
  • Medicinal fungi, taken whole or as various forms of extracts, have been used to alleviate, cure or prevent human ailments since pre-historic times. In particular, Asian cultures have incorporated a variety of mushrooms into their medical practices. Chemically pure, bioactive metabolites from fungi have been a mainstay of modern pharmacological research and in addition to antibiotics, include anticancer agents, immunosuppressants, enzyme inhibitors, antagonist and agonists of hormones, and a variety of psychotropic substances. However, to date not many studies have focused on the possible health benefits of odorant volatile organic compounds (i.e., gas phase compounds). An analysis of these compounds for their health related effects will expand the range of compounds available for the treatment of chronic and acute diseases. This review highlights phenolic acids and monoterpenes from Asian medicinal mushrooms (AMMs), which not only produce pleasant odors but also have antioxidant and antibacterial effects. Odorant bioactive volatile phase compounds from medicinal mushrooms remain an essentially untapped source for future medicines, and AMMs remain a promising resource for future pharmacological research.