• 생물정신의학
• /
• 제1권1호
• /
• pp.31-39
• /
• 1994

Anxiety and anxiety disorders are one of the most common and most serious psychiatric problems. Anti-anxiety drugs are one of the most effective treatment method for these problems. Benzodiazepines have various side-effects and the risk of overuse and abuse. Therefore, physicians should prescribe benzodiazepines carefully. However, they should not be discouraged from prescribing benzodiazepines when they have a knowledge of the pharmacological characteristics of these drugs and there is a clear indication for their use. Generally speaking, problems of benzodiazepine use such as dependence withdrawal symptoms, and cognitive impairment are more likely to occur with high dose, long-term use(more than 4 months), in geriatric patients and patients with a history of alcohol or other sustance abuse. But long-term or high-dose use can be jusified for patients with panic disorder of agoraphobia, and medically-ill patients with persistent anxiety that cannot be otherwise treated. In summary, there cannot be a general prescribing formulation for benzodiazepine use. Physician should always make their decision based on the individual patient's risk/benefit factors.

• 생물정신의학
• /
• 제1권1호
• /
• pp.7-16
• /
• 1994

I will try to serve as the basis for the development of a clinical therapeutic guideline of antipsychotic drugs. Knowing that many patients fail standard treatment recommendations, either because of insufficient efficacy or intolerance to adverse effects, led us to emphasize the importance of the guideline. The clinicians continually assimilate new information about recent advances, including : novel agents targeted to impact specific components of various neurotransmitter systems ; combination strategies ; alternative uses of existing agents ; and specialized requirements of a growing number of identified diagnostic subtypes. The cost to benefit ratio must always be considered when developing a therapeutic guideline.

• 생물정신의학
• /
• 제1권1호
• /
• pp.17-30
• /
• 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.

• 생물정신의학
• /
• 제24권3호
• /
• pp.162-166
• /
• 2017

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, medication-induced hypersensitivity reaction with long latency. It is characterized by fever, rash, leukocytosis with eosinophilia, atypical lymphocytosis, and internal organ involvement. The most common causes of DRESS syndrome are sulfonamides and anticonvulsants such as carbamazepine and lamotrigine. However, valproic acid and olanzapine could develop DRESS syndrome. We report a case of DRESS syndrome associated with valproic acid and olanzapine in a 41 years old male patient with bipolar disorder.

• 생물정신의학
• /
• 제24권3호
• /
• pp.83-94
• /
• 2017

Caregiving for the children seems to be one of the most challenging tasks for the parents who should devote themselves totally despite endangering them. From the evolutionary perspective, this human behavior must have been the advantage in the survival of the species and rooted in ethological origin. John Bowlby, a child psychiatrist, psychoanalyst, and great developmental researcher, had formulated the attachment theory linking psychoanalysis and ethology through evolutionary biology. His and later following researchers' outcomes have provided enormous influence on viewing parental caregiving and the insight of human relationships and interventions. This article overviews the attachment theory in terms of the goal oriented cybernetic system to gain the survival advantage of the offspring and investigates the evolutionary origin of the caregiving and attachment from the retiles of the Mesozoic era to the mammalian revolution and finally to the human being. Deeper understanding of the nurturance and adult relationships from the standpoint of evolution can provide clinical utility of awareness of clients' lives.

• 생물정신의학
• /
• 제9권1호
• /
• pp.3-7
• /
• 2002

Genes involved in the serotonin system are good candidates for the pathogenesis of mood disorder and mood-related disorders, such as eating disorder, obsessive-compulsive disorder, alcoholism, and suicide. Serotonin type 2A(5-HT2A) receptor gene promoter polymorphism(-1438A/G) has been reported. In this article, authors reviewed the literatures regarding association studies between -1438A/G and mood disorder and mood-related disorders. There are controversial results with limited data to date. Further researches on the -1438A/G in psychiatric disorders are required.

• 생물정신의학
• /
• 제8권1호
• /
• pp.162-166
• /
• 2001

The mirtazapine is a relatively new antidepressant that has noradrenergic and specific serotonin antagonist action(NaSSAs). This has been known as one of the most safest drugs because of its few side effects. Until now, there have been only one case report that mirtazapine causes a EPS side effect(restless leg syndrome). But the peculiar mechanism of this drug makes it impossible to explain the exact reasons why the mirtazapine could induce EPS symptoms. Authors observed three cases of mirtazapine induced akathisia. We could not explain the phenomenon the other way except akathisia. So here we presents the three case of mirtazapine induced akathisia and a few possible hypothesis of this phenomenon.

• 생물정신의학
• /
• 제8권1호
• /
• pp.111-115
• /
• 2001

An association study with Korean alcoholic patients(n=50) and normal controls(n=53) was performed to find the relationship between catechol-O-methyltransferase(COMT) gene polymorphism and alcoholism using polymerase chain reaction-restriction fragment length polymorphism. When we compared the allele and genotype frequencies of Nla III COMT gene polymorphism in alcoholism and normal controls, there was no significant difference between two groups. Our results do not support an association between the Nla III polymorphism of COMT gene and alcoholism.

• 생물정신의학
• /
• 제6권1호
• /
• pp.135-140
• /
• 1999

The authors described a case of male schizophrenia who developed myoclonic jerk repeatedly and one episode of convulsive seizure during the treatment of clozapine. According to literatures and reported cases, myoclonic jerks induced in a small amount of clozapine may precede and predict the development of a convulsive seizure. Therefore clinicians have to pay attention to the development of a myoclonic jerk during the administration of clozapine. They may decrease the dosage of clozapine step by step at first in the convulsive state, and observe EEG changes of patients frequently.

• 생물정신의학
• /
• 제6권2호
• /
• pp.149-152
• /
• 1999

Transgenic mice models of Alzheimer's disease were produced by overexpressing APP(amyloid precursor protein) mutant and presenilin mutant genes using the promotors that induced neuronal expression. The neuropathologies, electrophysiological changes and behavioral changes that were demonstrated in these transgenic mice models were amyloid changes, gliotic changes, A-beta increases, deficit in LTP(long-term potentiation) and behavioral changes. Some or all of the above changes were found in each transgenic mice model. These models generally showed amyloid neuropathology but they usually lacked the neurofibrillary tangles. So, they can be regarded as partial models of Alzheimer's disease. The development of them is undoubtedly the great progress toward future research.