• Title/Summary/Keyword: 정신과 약물

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NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY ATYPICAL ANTIPSYCHOTICS (소아청소년 정신과 영역에서의 새로운 약물치료 ; 비정형 항정신병약물)

  • Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.26-35
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    • 2003
  • Conventional antipsychotics are commonly used to treat children and adolescents suffered from schizophrenia to other neuropsychiatric conditions. Regrettably, studies for typical antipsychotics report high rates of sedation, orthostatic hypotension, and extrapyramidal side effects. Over the past few years, atypical antipsychotics have been prescribed for use in adults with psychotic symptoms. Child psychiatrists have begun using these drugs to children and adolescents hoping safe and better alternatives to the conventional antipsychotics. However, there is not enough short-term and almost no long-term data about atypical antipsychotics for pediatric patients. Therefore, the purpose of this article is to review what is known about the use of the atypical antipsychotics in young patients. To do so, an appropriate approach to the use of these drugs in child and adolescent patients my be offered.

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Neuropsychiatric Aspects of Pulmonary Disease (호흡기 질환의 신경정신과적 측면)

  • Nam, Beom-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.45-51
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    • 2009
  • Pulmonary diseases distress millions of people worldwide. Numerous studies have shown an association between pulmonary disease and psychiatric disorders. Despite this, little is known about the treatment of psychiatric disorder in patients with pulmonary disease. The three main goals of this article are 1) to discuss the major disorders such as asthma, chronic obstructive pulmonary disease, hyperventilation, tuberculosis, lung cancer that most clinicians see in practice, 2) to provide an information about psychiatric treatment such as anxiety, depression, psychosis in pulmonary disease, and 3) to provide some clinically relevant suggestions about pharmacologic interactions between pulmonary and psychotropic drugs.

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

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.133-142
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    • 2001
  • For treating various conditions of the psychosomatic disease, not only psychotropic drugs but also drugs used in internal medicine or other than psychiatric fields would be applied. So psychiatrists who are interested in psychosomatic medicine should make expanded knowledges of those medicine. And modalities of drug treatment should be modified according to the characteristics of illness behavior and disease concept which the patient have. Some drugs used in complementary medicine could be applied to the psychosomatic illness. For example, herbs and/or aromas which have some effects without serious adverse reactions could be used carefully to the patient. And the mode of action and efficacies of them should be evaluated by doctors.

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Treatment Strategies for Psychotic Depression (정신병적 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.234-243
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    • 2006
  • Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

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A Study on Sedation, Delirium and Fall in Mental Illness Taking Psychiatric Drugs (정신약물을 복용하는 정신질환자의 진정, 섬망, 낙상에 관한 연구)

  • Park, Kyung-Mi
    • Journal of Industrial Convergence
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    • v.18 no.4
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    • pp.33-40
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    • 2020
  • This study is a descriptive research study to understand the relationship between sedation, delirium, and fall of people with mental illness taking psychiatric drugs. From March10, 2019 to November 10, 2019, four psychiatric nurses were evaluated on 149 people with mental illness in two psychiatric hospitals located in D city. The collected data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficient using SPSS 22.0. Sedation and delirium(r=.587, p=<.001), sedation and fall(r=.273, p=.001), delirium and fall(r=.390, p=<.001)were all significant positive correlation. This study identified the degree of sedation, fall, and delirium of patients taking psychiatric drugs and confirmed the relationship between sedation, fall, and delirium of people with mental illness. It is thought that it will be able to provide basic data to prevent falls and delirium that may occur when taking psychiatric drugs and to prepare a nursing intervention strategy.

Clinical Efficacy of Clozapine in Refractory Schizophrenia (불응성 정신분열증환자의 Clozapine 치료효과)

  • Lee, Min-Soo;Jung, In-Kwa;Kwak, Dong-Il
    • Korean Journal of Biological Psychiatry
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    • v.2 no.1
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    • pp.131-139
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    • 1995
  • Clozapine, on atypical antipsychotic drug, has been estimated to be a major improvement in the treatment-refractory schizophrenic patients. We evaluated the clozapine efficacy in the treatment of schizophrenic patients who are refractory to classic neuroleptics. The patients were assigned in a prospective, open, comparative trial for 12 weeks. Following an dose titration, 33 inpatients with treatment-refractory schizophrenia diagnosed according to DSM-III-R were given a clozapine(N=17, approximate 300-600mg/day) or haloperidol(N=16, approximate 20-30 mg/day) for 12 weeks. The clinical state was assessed before treatment, and 1st, 4th, 8th and 12th week during treatment using Brief Psychiatric Rating Scale(BPRS) and Positive and Negative Syndrome Scale(PANSS). Assessment of side effects were mode weekly using Simpson-Angus Scale for Extrapyramidal Side Effects and Adverse Events-Somatic Symptoms. Clozapine produces significant improvement than haloperidol on the BPRS and PANSS scores. 77% (13/17) of the clozapine-treated patients were categorized as responders, who showed at least 20% decrease in total BPRS scores, compared with 31% (5/16) of haloperidol-treated patients. Extrapyramidal side effects occurred in only one patient in clozapine group, but nine patients in haloperidol group. Salivation, sleepiness, constipation and hypotension were most frequent adverse effects observed in clozapine group. There was no significant changes in total WBC and neutrophil during clozapine treatment. These findings suggest that clozapine is on effective antipsychotic drug for the Korean treatment-refractory schizophrenic patients, who are nonresponsive to or unable to tolerate classcal antipsychotic drugs due to extrapyramidal side effects.

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건강칼럼 - 특이한 현대병 '공황장애'

  • Yu, Byeong-Hui
    • The Science & Technology
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    • v.33 no.3 s.370
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    • pp.84-85
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    • 2000
  • 정신계통의 특이한 현대병 '공황장애'는 갑자기 가슴이 조여들고 숨이 막히면서 손발이 저리고 어지러워져 곧 쓰러질 것 같은 느낌이 20~30분간 계속되며 이 증상이 주기적으로 나타나는 정신계통의 질환이다. 정신과 질환임에도 불구하고 여러 가지 급성 신체증상들을 동반해 심장질환 등 내과 계통의 질환으로 오진하기 쉬운 질병이다. 대개의 경우 약물치료후 2~3개월이면 호전되고 1년반 정도 장기 약물복용이 필요하다.

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Management of Weight Gain and Obesity Associated With Antipsychotics (항정신병약물 사용과 연관된 체중 증가와 비만의 관리)

  • Lee, Na-Hyun;Lee, Jae-Chang
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.86-94
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    • 2021
  • Objectives : The risk of weight gain is high when using antipsychotic drugs, and the prevalence of obesity in people with mental illness is high. Obesity management in psychiatric patients is important because obesity causes various complications and lowers treatment adherence and quality of life. Methods : In this review, we summarized the management strategies for obesity that can occur when using antipsychotic drugs through a web search. Results : Evaluate obesity-related risk factors and related indicators from the beginning of treatment, and conduct regular monitoring. If an antipsychotic drug is used and obesity is induced, a change to a drug with a low metabolic risk may be attempted. Sufficient interventions are also needed on the need to manage obesity, a healthy diet, and exercises in patients and their families. If weight loss is not achieved and obesity-related complications are associated, the use of anti-obesity drugs may be considered. Pharmacological treatment approaches should be carefully considered. Conclusions : Non-pharmacological and pharmacological therapies can be applied to manage weight gain and obesity caused by the use of antipsychotic drugs. When using anti-obesity drugs, the characteristics of mental disorders, drug safety, and drug interactions should be considered.

Current Pharmacogenetics in Psychiatry (정신의학에서의 약물유전학 현황)

  • Kim, Il Bin;Lee, Yu Sang
    • Korean Journal of Biological Psychiatry
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    • v.28 no.1
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    • pp.1-6
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    • 2021
  • Pharmacogenetics is opening a new era of precision medicine in psychiatry. Drug-metabolizing enzymes are characterized by genetic polymorphisms, which render a large portion of variability in individual drug metabolism. Dose adjustment based on pharmacogenetics knowledge is a first step to translate pharmacogenetics into clinical practice. However, diverse factors including cost-effectiveness should be addressed to provide clinical recommendation. To address current challenges in pharmacogenetics testing in psychiatry, this review provides an update regarding genotyping (SNP analysis, array, and next-generation sequencing), genotype-phenotype correlations, and cost-effectiveness. The current updates on pharmacogenetics in psychiatry will provide guidance for both clinician and researchers to have a consensus in harmonizing efforts to advance the pharmacogenetics field in a part of precision medicine in psychiatry.

Pharmacotherapy for Patients Complaining With Somatic Symptoms (신체증상을 호소하는 환자의 약물치료)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.95-101
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    • 2021
  • Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.