• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.274-280
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• 1999

A variety of mechanism may generate pain resulting from injury to the central and peripheral nervous system. None of these mechanism is disease-specific, and several different pain mechanism may be simultaneously present in anyone patient, independent of diagnosis. Diagnosis of neuropathic pain is often easily made from information gathered on neurologic examination and from patient history. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if the neurologist has a complete understanding of therapeutic options, the mainstay of which is pharmacotherapy. Selection of an appropriate rharmacologic agent is by trial and error since individual responses to different agents, doses, and serum levels are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuropathic pain. Tricyclic antidepressants are first-line agents, although other drugs, including anticonvulsants, local anesthetic antiarrhythmics, clonidine, opiates, and certain topical agents, also offer pain relief in some patient populations. The novel antidepressants venlafaxine and nefazodone are potentially useful new drugs that are better tolerated than tricyclic antidepressants. Also Gabapentine seems an interesting and promising drug for the treatment of neuropathic pain.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.63-71
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• 2023

Urinary incontinence (UI), affecting 3%-11% of males and 25%-45% of females globally, is expected to rise with an aging population. It significantly impacts mental health, causing depression, stress, and reduced quality of life. UI can exacerbate psychiatric conditions, affecting treatment compliance and effectiveness. It is categorized into transient and chronic types. Transient UI, often reversible, is caused by factors summarized in the acronym DIAPPERS: Delirium, Infection, Atrophic urethritis/vaginitis, Psychological disorders, Pharmaceuticals, Excess urine output, Restricted mobility, Stool impaction. Chronic UI includes stress, urge, mixed, overflow, functional, and persistent incontinence. Drug-induced UI, a transient form, is frequently seen in psychiatric treatment. Antipsychotics, antidepressants, and other psychiatric medications can cause UI through various mechanisms like affecting bladder muscle tone, altering nerve reflexes, and inducing other conditions like diabetes or epilepsy. Specific drugs like lithium and valproic acid have also been linked to UI, though mechanisms are not always clear. Managing UI in psychiatric patients requires careful monitoring of urinary symptoms and judicious medication management. If a drug is identified as the cause, options include discontinuing, reducing, or adjusting the dosage. In cases where medication continuation is necessary, additional treatments like desmopressin, oxybutynin, trihexyphenidyl, or amitriptyline may be considered.

• Korean Journal of Social Welfare
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• v.69 no.3
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• pp.165-191
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• 2017

The purpose of this study is to identify the major predictive factors of intention of drug users to use treatment services. The theoretical framework was used extended Behavioral Model of Health Services Use which integrates the Andersen model and the Theory of Planned Behavior. Thus, this study examined the effects of individual characteristics(predisposing, enabling, need factor) and attitude, subjective norm, perceived behavior control on drug users' intention to use treatment services. Factors with a statistically significant effect were as follows: from the individual characteristics - gender and past treatment experiences of the predisposing factors along with psychiatric diagnosis, anxiety and depression, and severity of drug abuse of need factors. From the Theory of Planned Behavior - subjective norm and perceived behavior control turned out to have impacts on their intention to use treatment services. The study emphasizes that a concern of women, increasing positive experiences of treatment, efforts to change the subjective norms and perceived behavior control of drug users to promote their determination to get treatment.

• Korean Journal of Biological Psychiatry
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• v.14 no.4
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• pp.232-240
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• 2007

Objectives : Vascular endothelial growth factor(VEGF), one of potent cytokines, and its receptors were related with various biological functions and pathological conditions. The purpose of this study was to investigate the changes of serum level of free VEGF, soluble VEGFR-1, and soluble VEGFR-2 after treatment with atypical antipsychotic drug in schizophrenia. Method : The schizophrenic patients were diagnosed with DSM-IV and were prospectively followed up for 4 and 8 weeks. Thirteen schizophrenic patients were evaluated their clinical assessment with serum levels of free VEGF, sVEGFR-1, sVEGFR-2, and positive and negative symptom scale(PANSS) at baseline, 4 weeks, and 8 weeks after treatment with atypical antipsychotic drug. Thirteen normal control subjects were recruited and matched with the patient group by age and sex. Result : The serum level of free VEGF($295.2{\pm}43.7$pg/ml)and sVEGFR-2($8259{\pm}336.7$) at baseline(before treatment) in schizophrenic patients were not significantly different, compared with the control group($199.0{\pm}28.8$ and $8481{\pm}371.9$) respectively. However, the serum level of sVEGFR-1($86.2{\pm}10.3$, p<0.05) was significantly increased in the schizophrenic patients compared with the control group($59.0{\pm}6.4$). After treatment with antipsychotic drug, the serum levels of free VEGF at 4 weeks($338.9{\pm}56.5$) and 8 weeks($309.5{\pm}58.7$) were not significantly, different compared with baseline. But the serum levels of sVEGFR-1 was significantly decreased at 8 weeks ($57.3{\pm}6.3$, p<0.05) after antipsychotic drug treatment. The serum levels of sVEGFR-2 were decreased at 4 weeks ($7761{\pm}403.0$, p<0.05) and 8 weeks($7435{\pm}333.5$, p<0.05) compared with baseline. Conclusion : The decreased serum level of sVEGFR-1 and sVEGFR-2 might be affected by dopaminergic system which was influenced by antipsychotic drug.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.80-98
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• 2022

Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

• Journal of Korean Neuropsychiatric Association
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• v.57 no.4
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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.

• 대한치과마취과학회:학술대회논문집
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• 2005.09a
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• pp.36-37
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• 2005

1. 술자가 확실히 수련 받을 때 사용하고, 완전히 익숙해진 약제와 술식만을 사용하여야 한다. 2. 치료의 범위와 종류, 정신적인 필요, 의학적인 상태에 따라서, 필요한 환자에게만 제한적으로 사용하여야 한다. 3. 각 환자의 상태를 술전에 충분히 평가하여야 한다. 4. 치료가 시작해서 끝날 때까지 계속해서 Monitoring을 하여야 한다. 5. 적절한 어린이용 응급약물, 장비, 시설을 갖추고 유지 관리하여야 한다. 6. 사용된 약물의 투여시간, 용량, vital sign, 부작용에 관한 문서화된 기록을 남긴다. 7. 수련 받은 인력을 확보하여야 한다, 8. 위험성이 높은 환자응 병원 혹은 병원급의 시설, 장비가 구비된 곳에서 치료한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.129-138
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• 2002

Objectives：In order to treatment guideline of ADHD, present clinical practise of child psychiatrists and their opinion of optimal intervention were evaluated. Methods：Structured questionnaire items about diagnostic workup, drug choice of 5 different situations according to different co-morbid disorders, and non - pharmacological treatment were applied to 32 child psychiatrists working at university and general hospital. we compared the data with Texas Algorithm Project guideline. Results：(1) Intelligence Test, Sentence Completion Test, sustained attention test, and Conner's questionnaire were the basic routine test that must be performed. (2) Main trend of medication in this study was not different from TAP guideline. (3) In case of co-morbid tic disorder, first recommending drug is still psychostimulant in the TAP guideline. But in this study initial psychostimulant prescription was not main trend. (4) In case of MPH non-response co-morbid disruptive behavior disorder, MPH medication combined with other drug were more common than switching to other drug as suggested the TAP guidelines. (5) In non-pharmacological treatment, most child psychiatrists reported the importance of parent management. Conclusion：There were some difference in medication trend in this study compared with TAP guideline. Further study and conference are needed for experts consensus in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.65-73
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• 1995

We conducted the comparative study of the effects of the parent training combined with medication and the medication only on 23 ADHD children with the age from 5 to 11(body 22, girl 1). Mothers of combined treatment group(parent training+medication) attended, the parent training program once a week for 8 consecutive weeks and booster session 1 month later. Children of both groups were assessed twice before and after treatment using the various using scales and TOVA to evaluate the treatment effects. The results of present study showed the greater effectiveness of the medication+parent training over the medication only in reducing the parenting stress of mothers as well as the inattention and behavioral problems of ADHD children. In medication only group while the scores of mother's rating did not change significantly after treatment, those of teacher's rating and TOVA tend to be decreased to normal range. These results suggested that methylphenidate is effective on improving attentional problems of ADHD children, but not on behaviral problems at home. These results mean that parent training is needed for reducing behavioral problems of ADHD children, negative interactions in mother-child relation, and parenting stress as well as maxmizing medication effect.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.1 no.1
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• pp.89-93
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• 1990

60 Attention-deficit hyperactive patients treated with stimulant drugs such as methylphenidate and pemoline were evaluated in regards to the therapeutic benefit and side effects of these drugs. The results were as follows : 1) Of the 60 subjects 34 showed considerable imporvement and only 8 showed little or no improvement. 2) Hyperactivity, inattention and impulsivity were improved markedly by stimulants These behavioral changes were accompanied by improved performance in classroom. 3) School age children tended to show more improvement than preschool children or adolescence. 4) Of the 60 subjects 25 showed no side effect and only 6 showed severe side effects, and common side effects were decreased appetite, insomnia and irritability or nervousness. It is the author's impression that despite of the therapeutic efficacy of these drugs when they were administered on a short-term basis, long-term outcome dose not seem to be altered by the administration of these agents.