• Korean Journal of Biological Psychiatry
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• v.7 no.1
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• pp.34-45
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• 2000

Pharmacotherapy of bipolar disorder is a rapidly evolving field. Mood stabilizers and anticonvulsants have varying biochemical profiles which may predispose them to different adverse effects and drug-drug interactions. Several of the new anticonvulsants appear less likely to have the problems with drug-drug interaction. To provide more effective combination pharmacotherapies, clinicians should be allowed to anticipate and avoid pharmacokinetic and pharmacodynamic drug-drug interactions. We reviewed the role of cytochrome P450 isozymes in the metabolism of the drugs and their interactions. The drug-drug interactions of several classes of drugs which used as mood stabilizers and new anticonvulsants, some of which may have psychotropic profiles, are discussed mainly in this article. Finally, potential pharmacokinetic interactions between the benzodiazepines and other coadministered drugs are discussed briefly.

• CELLMED
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• v.11 no.3
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• pp.14.1-14.9
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• 2021

Background: Cuscuta reflexa Roxb is a member of the Cuscutaceae family, and in Unani medicine, it is known as Aftimoon. It is a parasitic plant that can be found growing abundantly on various host plants in India up to 3000 metres in altitude during the rainy season. Unani physicians have been using it for years to cure a variety of illnesses, including psychiatric illnesses like melancholia, schizophrenia, and epilepsy. It has been used to cure hepatitis, palpitations, and skin disorders, among other things. Objective of the study: To evaluate anti-anxiety effect of Cuscuta reflexa Roxb in Swiss Albino mice of either sex. Materials and Methods: A total of 24 Swiss Albino mice weighing 25-35 g were used in this study. Animals were chosen at random and held in their cages for at least 7 days in a standard setting. Group A was given regular saline as a vehicle, Group B was given a hydro alcoholic extract of the lower dose of the test drug, Group C was given a hydro alcoholic extract of the higher dose of the test drug, and Group D was given the standard drug Diazepam 5 mg/kg orally. Aftimoon as hydro alcoholic extract (200 mg/kg and 400 mg/kg body wt.) was given in single and double doses and observed for 7 days. Results: For each parameter in each category, mean and standard deviations were computed. For multiple group comparisons, a one-way ANOVA was used, followed by Turkey's post hoc test. (p<0.05) was used as the significance standard. Conclusion: These results advocate that the Aftimoon as double dose (400 mg/kg body wt.) revealed anti-anxiety effect similar to standard drug.

• Korean Journal of Biological Psychiatry
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• v.1 no.1
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• pp.31-39
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• 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.

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.131-132
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• 1996

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.25-29
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• 2016

Background: The most important reason for pre-operative administration of medication is to reduce anxiety. Alleviation of fear and anxiety about surgery enables patients to remain comfortable during treatment. Dexmedetomidine (DEX) is a fast-acting drug that is used as a premedication in different circumstances because it has sedative and anti-anxiolytic effects, and stable hemodynamics. It also has the advantage of intranasal administration. The aim of this study was to investigate the effects and hemodynamic stability of DEX by retrospectively analyzing cases in which DEX was administered nasally as a premedication. Methods: Ten patients treated at Dankook University Dental Hospital, recruited between February and April 2015, received intranasal delivery of $2{\mu}g/kg$ DEX, 30 minutes prior to general anesthesia. Anesthesia records of anxiety, blood pressure, respiration, pulse, estimated arterial oxygen saturation ($SpO_2$), and partial pressure, or maximum concentration, of carbon dioxide ($ETCO_2$) were analyzed. Results: Administration of DEX prior to a general anesthetic effectively relieved anxiety. Respiratory depression, the most severe adverse effect of other sedatives, was not observed. Hemodynamic stability under general anesthesia was maintained during treatment and a reduction in emergence delirium was observed upon completion of treatment. Conclusions: Premedication administration of DEX is safe for pediatric patients undergoing dental treatment under general anesthesia.

• Journal of Digestive Cancer Research
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• v.11 no.2
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• pp.108-113
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• 2023

Dyspnea is a common symptom among patients with gastrointestinal cancer, and a comprehensive evaluation of their respiratory function is essential. Self-reporting aids in the assessment of the degree of dyspnea, while objective examination methods are performed to identify the potential underlying causes when subjective symptoms are present. Standard treatment protocols should be followed for potentially reversible and common causes of dyspnea, such as pleural effusion, pneumonia, airway obstruction, anemia, asthma, exacerbation of chronic obstructive pulmonary disease, pulmonary thromboembolism, or drug-induced interstitial lung disease. Careful and close monitoring is required due to the high frequency of pulmonary thromboembolism and the risk of cardiovascular accidents, drug-induced interstitial lung disease, or other complications from some anticancer drugs. In case of hypoxemia with an oxygen saturation of 90% or less, palliative treatment should comprise standard oxygen therapy such as nasal cannula, mask, or high-flow nasal cannula. If non-pharmacological oxygen therapy is not effective, pain control through systemic narcotic analgesics and anti-anxiety therapy with benzodiazepines may be helpful.

• Journal of Haehwa Medicine
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• v.9 no.1
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• pp.711-724
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• 2000

I reached following conclusion through a bibliographic study about the drug dependence. 1. The drug dependence is the case that taking drugs continually in order to get around discomfort and get mental drug efficacy. that is also the state of poisoning that shows compulsions that using all means to get drugs. the drug dependence is coincident with alcolism in Oriental Medicine. 2 Medicinal matters that causes the drug dependence consist of two field. one is licit drugs, including a tranquilizer, a sleeping pill, anti-anxiety drug, alcohol, caffeine, tobacco, etc. the other is illict drugs, including opium products, psychostimulant, a hallucinogen, aromatic agent(adhesives, LSD, etc.) 3. Drugs that causes dependences has the habit which causing mental dependences and the medicinal poisining which causing physical dependences. 4. A syndrome of abstain from the drug which rides on all kinds of drugs is analogous to depressive psychosis, epilepsy, insanity, depressive syndromes, disorder of internal organs, histery, dizziness, etc. 5. The drug dependence causes visceral dysfunction, that is chiefly inflammatory lesion of brain, heart lung etc. (inflammatory lesions os mainly due to infect.) and injuries liver which removes toxic agents and kidney which is an excretory organ. 6. The treatment of the drug dependence, which needs at first check the medical record and the syndrome, is consist of the expectant treatment and isolating treatment as a rule and sometimes mental therapeutics is going on at the same time. 7. The oriental medical cure of the drug dependence needs more concrete study.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.172-180
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• 2016

Background: Ischemic heart disease is the most common type of heart disease and an important cause of death in Korea. Among marketed anti-anginal medications, molsidomine, nicorandil, and trimetazidine are approved in Korea with unique mechanism of actions. As these drugs are not approved by the US Food and Drug Administration, the access to the up-to-dated and comprehensive safety-related information has been less than optimal from drug information resources used by Korean pharmacists. Methods: A systematic review was conducted using Embase and Korean manuscripts to compile safety updates for these medications. Out of 418 articles from keyword searches, 52 studies were reviewed in full to compare adverse effects (AEs) with the approved package inserts (PI). Results: Molsidomine related adverse effects were mostly mild or moderate, but anxiety, palpitation, epigastric pain, and sexual potency reduction were additional AEs found from the review not listed in PI. Although PI has included ulceration in oral cavity and gastrointestinal tracts including anus by nicorandil, the Korea FDA recently recommended adding corneal, genital, and skin ulcers to the approved PI. Trimetazidine induced Parkinsonism, worsening of the symptoms for patients diagnosed with Parkinson's disease, gastrointestinal burning, and muscle cramps were additionally identified AEs not listed in PI for trimetazidine. Conclusion: Continuous evaluations of the safety profile of these agents are needed to balance the risks and benefits to provide evidence-based safety counseling to the patients. In addition, more focused efforts on spontaneous reporting are warranted by healthcare professionals to safeguard patients against AEs.

• 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.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.265-271
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• 1997

Objective : A 4-week, single-blind, parallel group study was conducted to evaluate the efficacy and safety of tofisopam and lorazepam in 32 outpatients with anxiety disorder. Methods : Patients were randomized to receive either tofisopam(N=17) or lorazepam(N=15). The starting dose of tofisopam was 50mg t.i.d. daily, which could be increased to a maximum of 100mg t.i.d. according to the patient's clinical response and side effect. The starting dose of lorazepam was 0.75mg b.i.d. daily, which could be increased to a maximum of 1.5mg b.i.d. depending on the patient's clinical response and side effect. Efficacy evaluations at baseline, week 1, 2, and 4 used the 14-item Hamilton Rating Scale for Anxiety(HAM-A) and Clinical Global Impression(CGI). Tolerability was assessed by response to a nonleading question concerning adverse events. Laboratory parameters including vital sign, EKG, hematological, and biochemical values were measured during trial. Results : No significant differences between HAM-A total scores, two HAM-A factors(psychic, somatic) and CGI severity scores were recorded at any point during tofisopam and lorazepam treatments. However, in each group there was a significant decrease in HAM-A total scores, two HAM-A factor s(psychic, somatic), CGI severity scores over time. The pecentages of patients with tofisopam who at least minimally improved increased from 64.7% at week 1 to 94.1% at week 4. The pecentages of patients with lorazepam who at least minimally improved increased from 40.0% at week 1 to 66.7% at week 4. The pecentages of patients with tofisopam who had not any adverse event increased from 58.8% at week 1 to 87.9% at week 4. The pecentages of patients with lorazepam who had not any adverse event were not changed from 46.7% at week 1 to 46.7% at week 4. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial in both groups. Conclusion : These data suggest that tofisopam may be effective in reducing anxiety and is a anti-anxiety drug of identical potency with lorazepam. Tolerability of tofisopam was superior to lorazepam. These findings should be confirmed by using double-blind crossover study with a large member of patients.