• 고려인삼학회:학술대회논문집
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• 고려인삼학회 1978년도 학술대회지
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• pp.19-20
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• 1978

• 대한불안의학회지
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• 제2권2호
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• pp.94-100
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• 2006

Objective : This study was designed to examine the volumetric abnormality of orbitofrontal cortex (OFC) and its change after 2 years of pharmacotherapy in obsessive compulsive disorder (OCD) patients. Method : Volumetric magnetic resonance imaging studies were conducted in 15 OCD patients and 13 normal volunteers. For 2 years, all patients took at least one serotonin reuptake inhibitor and atypical antipsychotics were used as an augmentation therapy in most patients. The follow-up MRI studies were conducted after the pharmacotherapy and OFC volumes were measured by the manual region of interest method. Results : Bilateral OFC volumes of 15 OCD patients were significantly greater than those of the normal volunteers before the treatment. After 2 years of the treatment, significant decrease was observed in bilateral OFC volumes of OCD patients to the extent that left OFC volume of OCD patients was not different from that of the normal volunteers. Conclusion : This finding suggests that OFC is directly related to the pathophysiology of obsessive compulsive disorder.

• 생물정신의학
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• 제8권2호
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• pp.226-232
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• 2001

The pharmacotherapy of depression has reduced morbidity and improved outcome for many depressive patients. A wide range of classical and new antidepressants are available for their treatment. However, 30-40% of all patients do not respond sufficiently to the initial treatment and present adverse effects. Pharmacogenetics studies the genetic basis of an individual's ability to respond to pharmacotherapy. Recently, some reports on serotonin transporter gene polymorphisms and their influence on the response to antidepressive therapy provide an interesting diagnostic tool in assessing the chances of response to antidepressants. We also investigated the relationship between serotonin transprter polymorphisms(5-HTTLPR) and the long-term effect of the antidepressant treatment. 128 depressive patients were enrolled into 2nd year study. The therapeutic response of each subset was not different at 8th, 16th week, but the subset with homozygote(l/l) of long variant showed a better therapeutic response to antidepressant than the heterozygote(l/s) of long and short variant, which showed a better therapeutic response than the subset with homozygote (s/s) of short variant at 1st year and 2nd year after the antidepressant treatment. This result shows that the serotonin transporter polymorphisms may be related to the long-term effect of antidepressant treatment. The potential for pharmacogenomics, the use of genetic information to guide pharmacotherapy and improve outcome by providing individualized treatment decisions, has gained increasing attention. pharmacogenomics will contribute to individualize drug choice by using genotype to predict positive clinical outcomes, adverse reactions, and levels of drug metabolism. Personalized medicine, the use of marker-assisted diagnosis and targeted therapies derived from an individual molecular profile, will impact the antidepressant therapy and this approach will replace the traditional trial-and-error practice of medicine.

• 한국정밀공학회지
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• 제25권5호
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• pp.148-154
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• 2008

Pharmacotherapy was mainly used to treat osteoporosis. However, some researches showed that pharmacotherapy could induce unexpected adverse effects. Some studies showed that whole body vibration affected beneficially osteoporosis. This paper studied the effect of whole body vibration fur osteoporosis compared with the effect of pharmacotherapy. 10 female rats were used and allocated into 4 group, CON, SHAM, DRUG, and WBV. Rats except SHAM group were ovariectomised to induce osteoporosis. Rats in WBV group were stimulated in whole body vibration at magnitude of $1mm_{peak-peak}$ and frequency 45Hz, for 8 weeks (30 min/day, 5 days/week). Rat in DRGU group was orally administered the Actonel (0.58mg/Kg), for 8 weeks (5days/week). The $4^{th}$ lumbar in rats were scanned at a resolution of $35{\mu}m$ at baseline, before stimulation, and 8 weeks after stimulation by In-vivo micro computed tomography. For detecting and tracking changes of biomechanical characteristics (morphological and mechanical characteristics) in lumbar trabecuar bone of rats, structural parameters were measured and calculated from acquiring images and finite element analysis was performed. In the results, loss of quantity and change of structure of trabecular bone in WBV group were smaller than those in both CON and SHAM groups. In addition, mechanical strength in WBV group was stronger than that in both CON and SHAM groups. In contrast, biomechanical characteristics in WBV group were similar with those in DRUG group. These results showed that reasonable whole body vibration was likely to treat osteoporosis and be substituted partly for drug treatment.

• 정신신체의학
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• 제28권1호
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• pp.53-62
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• 2020

연구목적 최근 공황장애와 초기 외상 사건에 대한 연구결과가 축적되는데, 아직까지 공황장애의 경과나 치료와 아동기 외상 연구는 드문 실정이다. 이 연구는 공황장애 외래 환자에서 아동기 외상 병력과 약물치료 유지 기간 사이의 상관 관계를 조사하였다. 방 법 이 횡단적 연구는 한 대학병원 정신건강의학과 외래를 방문한 공황장애 환자를 대상으로 일생의 외상력, 우울, 불안 및 외상후 스트레스 증상과 약물치료 기간을 조사하였다. 2012년 3월~2016년 2월까지 총 135명의 공황장애 외래 초진 환자를 대상으로 설문지 연구를 실행하였으며 이중 53명(39%)이 거절하거나 불완전한 설문을 작성하여 나머지 82명의 자료를 분석하였다. 설문지에는 외상력 선별 검사(Trauma History Screen), 벡우울척도, 벡불안척도, 간편 외상후 스트레스 장애 체크리스트 설문지가 포함되었다. 결 과 일생 동안 경험한 외상 종류의 수와 치료기간은 음의 상관관계를 나타내었다(rho=-0.269, p=0.015). 외상의 아형을 볼 때는 아동기 신체 학대와 치료 기간 사이에 유의한 부정 상관 결과를 보였다(rho=-0.298, p=0.007). 결 론 이 연구의 결과는 심리적 외상, 특히 아동기의 대인관계적 외상이 공황장애의 치료 유지에 영향을 줄 수 있는 것을 시사한다. 향후 연구에서는 아동기 외상과 불량한 치료 유지를 중재하는 요인, 예를 들어 치료 관계나 치료에 대한 기대 부족 등에 대한 연구가 필요하다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제21권3호
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• pp.174-181
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• 2010

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

• 대한조현병학회지
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• 제22권2호
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• pp.21-33
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• 2019

Objectives: The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients. Methods: An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire. Results: For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used. Conclusion: Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.

• 한국임상약학회:학술대회논문집
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• 한국임상약학회 2007년도 추계학술대회
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• pp.182-182
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• 2007

• 한국임상약학회지
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• 제23권4호
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• pp.291-299
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• 2013

Purpose: Problem-based learning (PBL) has been adopted to foster active and self-directed learning and enhance critical thinking and problem-solving skills in many health-care academic disciplines in Korea. Interest in PBL has rapidly grown with a 6 year pharmacy degree program in Korea. The objective of this study was to evaluate feasibility of PBL, student satisfaction and academic performance with a self-assessment survey questionnaire. Method: Sixty students participated in the PBL for pharmacotherapy course. Average scores from student self-assessment on participation, satisfaction, and academic performance were $3.85{\pm}0.55$, $2.94{\pm}1.04$, $3.09{\pm}0.91$ out of 5 point lickert scale (1-do not agree at all, 5-agree completely), respectively. Results & Conclusion: The level of participation was positively correlated with improvement of communication skill in academic performance (correlation coefficient 0.27, p=0.037). In the quality analysis of the cases provided for PBL, students who participated more in the PBL greatly agreed the cases given were appropriate to learn fundamental knowledge for each disease state. The students disagreed that PBL was fun. The students stated that PBL was good to experience self-directed learning and clinical context beforehand but too time-consuming to devote and too demanding to commit. Lack of facilitator and insight on active learning should be rectified for successful launch of PBL in Korean pharmacy education.

• 생물정신의학
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• 제7권2호
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• pp.131-139
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• 2000

Even the pharmacotherapy is more effective than placebo for the treatment of depression, the outcome of pharmacoltherapy remains unsatisfactory for many patients. Apart from side effects, there are two major limitations of antidepressant therapy. One is the delayed onset of improvement and another is partial response. In order to address these clinical dilemmas, many psychiatrists more commonly employ add-on therapy. In past, the practice of using multiple drugs to enhance treatment response was called polypharamcy, and was disparaged as poor clinical practice. However, with improved understanding of how drugs affects the central nervous system and increased communication in journals and on computer networks about the relative merits of specific combinations, the scientific basis for the combining drugs is being defined. Indeed, the use of multiple medications as a stratege to enhance response has become both acceptable and widespread now a days. It is now referred to more positively as add-on therapy, co-medication, combination therapy, or drug augmentation. Thus, as the methods of practical strategies for treatment of depression, switching classes antidepressant drugs, combination therapy, augmentation strategies and brief treatment algorithm will be presented with items of considerations. However, when combination of drugs being tried, knowledges about the action of mechanism, pharamcokinetics, and pharmacodynamics are essential to cope with the possible adversive reactions and to get the appropriate responses for the treatment of depressive symptoms.