• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.140-146
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• 2001

In clinical setting, treatment-refractoriness, medication induced tardive dyskinesia and amenorrhea in chronic schizophrenia are frequently problematic. However, there are few guideline solving these problem available to clinicians. The goal of this study was collecting clinical data on clinical effectiveness and predictors of response of switching to olanzapine. We attempted to switch to olanzapine from risperidone and clozapine in chronic 31(risperidone 17, clozapine 14) schizophrenia and schizoaffective disorder patients suffering from sustained symptoms, weekly blood monitoring, medication induced tardive dyskinesia and amenorrhea. Previous antipsychotics dosage was gradually decreased for 2 or 3weeks, at the same time olanzapine dosage was gradually increased. At baseline, after 1 week, after 2 weeks and after 4 weeks we checked Brief Psychiatric Rating Scale, Clinical Global Impression Scale, Sympson-Angus Rating Scale, Barnes Akathisia Rating Scale and followed up after 12 months. Successful switch after 4 weeks was achieved in 25 patients(clozapine 9(64.2%), risperidone 16(94.1%)). Overall, mean BPRS and CGI scores increased significantly. Successful maintenance after 12 months was achieved in 17 patients(clozapine 5(35.7%), risperidone 12(70.5%)). Overall, mean BPRS and CGI scores increased significantly too. Switching to olanzapine from other atypical antipsychotics is recommendable in chronic schizophrenia with treatment refractoriness and drug induced side effect.

• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.282-286
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• 2010

Objective : The aim of the present study was to assess the effect of lumbar disc herniation surgery for low back pain on the erectile functioning. Methods : Thirty-eight patients, with age ranging from 22 to 56 years, who had presented with pain due to herniated lumbar discs were included in the study. International Index of Erectile Function (IIEF) Short Form questionnaire was used to evaluate the erectile functioning. Patient visits on the 1st week,1st month and 3rd month postoperatively were analyzed. Pain scores were also noted together with side effects and the complications of the surgery. Results : Of the 38 patients, 18 patients had reported erectile dysfunction; 10 patients mild and 8 patients moderate erectile dysfunction. Twenty patients did not report erectile problems. The herniation levels mostly were L5-S1 in 12 (31.6%). Overall, erectile dysfunction rates have improved in 31.7% of those previously with erectile dysfunction in a 3 month period after the surgery. Best results were obtained in those patients with mild erectile dysfunction preoperatively. Conclusion : Mild erectile dysfunction together with radiculopathy tends to improve after lumbosacral disc surgery. Moderate and severe erectile dysfunction may be related to a more severe nerve injury or to vascular and/or psychiatric factors. An evaluation of erectile functioning should routinely be performed in patients with lumbosacral disc disease both for data accumulation and for medico legal causes since the documentation of the correlation between erectile dysfunction and lumbosacral disc disease is still lacking.

• Journal of Menopausal Medicine
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• v.24 no.3
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• pp.204-209
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• 2018

Objectives: Aim of present study was designed to investigate the soporific effect of fennel among menopausal women. Methods: The present double-blinded and placebo-controlled trial examined the fennel effect on Pittsburgh Sleep Quality Index (PSQI). Total score and relevant 7 components, including sleep duration, sleep latency, use of sleeping medication, subjective sleep quality, sleep disturbances, daytime dysfunction and habitual sleep efficiency among 50 menopausal women compared to control group within a 12-week follow-up. Results: The patients in both groups reported no certain side effects and all subjects completed the study. The mean actual sleep duration was 5 hours and 66 minutes. Intergroup comparison revealed no statistically significant differences in the mean total PSQI score (P = 0.439), subjective sleep quality (P = 0.826), habitual sleep efficiency (P = 0.127), sleep disturbances (P = 0.130), use of sleeping medication (P = 0.52) and daytime dysfunction (P = 0.439). A tendency toward significant between 2 groups was seen concerning the sleep duration (P = 0.059). Intergroup comparison showed significantly borderline levels (P = 0.059). Conclusions: The treatment of 12 weeks with fennel caused a slight effect that did not reach to significant. These findings should be considered cautiously because of small sample size, short-term follow-up and subjective measure of sleep quality.

• Health Policy and Management
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• v.30 no.2
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• pp.178-184
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• 2020

Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

• Korean Journal of Biological Psychiatry
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• v.7 no.1
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• pp.80-84
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• 2000

Background : Hypersalivation can be a troublesome side effect of clozapine, limiting its usefulness in the management of some cases of schizophrenia. But the pharmacodynamic basis of clozapine-induced hypersalivation remains obscure. Object : The aim of this study was to evaluate the effect of the ${\alpha}_2$-adrenergic agonist clonidine on clozapine-induced hypersalivation in the patients who were receiving clozapine. Method : Twenty one schizophrenic inpatients on clozapine participated in the study. The amount of saliva was measured on the 7th day at 8pm after starting clozapine treatment. Of them, 15 patients who had experienced hypersalivation was treated with 0.1mg/day of clonidine. Result : Of 21 schizophrenic patients treated with clozapine in the psychiatric inpatient clinic, 15(71.4%) complained hypervalivation. After clonidine treatment, mean salivary flow-rate was decreased significantly in these patients. Conclusion : Clozapine-induced hypersalivation could be decreased by administration of ${\alpha}_2$-adrenergic agonist clonidine and compliance could be improved. Also our study supports the notion that increased adrenergic tone contributes to clozapine-induced hypersalivation.

• Korean Journal of Biological Psychiatry
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• v.7 no.2
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• pp.191-197
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• 2000

Objectives : Risperidone is a new antipsychotic drug developed to overcome the therapeutic limitation of conventional antipsychotics. It responses to negative as well as positive symptoms by blocking both dopaminergic and serotonergic receptors, causing no significant side effects such as agranulocytosis and seizure. It is, however, not known whether it induces any serious cardiovascular side effects as evoked by other conventional antipsychotic drugs. The aims of this study were to evaluate the effect of risperidone on cardiovascular function, and to discuss the factors affecting the cardiovascular function. Methods : For 42 patients(22 males and 20 females) diagnosed as schizophrenia, schizophreniform disorder or schizoaffective disorder according to the DSM-IV classification, the cardiovascular fuctions such as heart rate, systolic and diastolic blood pressure, PR interval, QRS interval and QT interval were successively checked before and after 2 weeks and 4 weeks risperidone administration. Furthermore, variables such as body weight, Brief Psychiatric Rating Scale(BPRS), Clinical Global Impression(CGI), Extrapyramidal Symptom Rating Scale(ESRS), Anticholinergic Rating Scale(ARS), serum cholesterol level, serum triglyceride level, serum high-density-lipoprotein level, serum WBC, serum Hb, serum platelet level, prothrombin time and partial thromboplastin time were also analyzed before and after 2 weeks and 4 weeks risperidone administration. Results : 1) Risperidone treatment resulted in a significantly decreased heart rate and increased QT interval after 4 weeks administration(p<0.005 respectively). 2) The scores of BPRS and CGI were significantly decreased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). The scores of ESRS and ASRS were significantly increased after 2 weeks and 4 weeks risperidone administration as compared with baseline(p<0.001 respectively). 3) There were positive correlations between heart rate after 4 weeks and total dose(P<0.05). Blood pressure was significantly(p<0.05) correlated with sex(higher in male) and significantly(p<0.05) positive correlated with body weight. QT interval was significantly(p<0.05) correlated with sex(longer in female) and smoking history(shorter in smokers). Conclusions : Risperidone could induce significant change in heart rate and Q-T interval. Therefore, the cardiovascular safety for risperidone should be reconsidered according to the duration and dosage increase.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.112-118
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• 2018

Objectives : Delirium is one of the most common mental illnesses that can affect cognitive function. Melatonin has been shown to be effective in the treatment of insomnia, and recent studies have shown a protective effect to prevent delirium. This study was conducted to investigate the efficacy of melatonin in delirium patients. Methods : All patients were referred to psychiatric department for insomnia and symptoms of delirium, and were diagnosed delirium by the DSM-5 diagnostic criteria. We compared base line severity of delirium with K-DRS-R-98-R (Korean version of Delirium Rating Scale revised 98) and after taking 2mg of melatonin, retrospectively. The side effects were also identified by referring to the medical records. Results : A total 21 patients had taken melatonin for insomnia and delirious symptoms. The K-DRS-R-98 scores were decreased from $15.24{\pm}2.64$ before treatment to $6.57{\pm}5.42$ after treatment. And CGI-S scores were also decreased from $4.14{\pm}0.48$ before treatment to $2.81{\pm}0.93$ after treatment (p<0.05). Conclusions : This study illustrates the possibility of melatonin as an effective treatment option for delirious symptoms such as disorientation, motor agitation, lability of affect and hallucinations as well as insomnia, with less concerns of drug side effect. Further study with a larger sample and prospective design will be required to confirm these results.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.281-286
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• 1995

Objects : Manic phase of bipolar disorder is treated with a combination of mood stabilizer and antipsychotic drug, especially in the acute phase. Such combined treatment is often required for the clinical management of manic symptoms until therapeutic effects of mood stabilizer become evident. The present study was the first open trial to evaluate the efficacy of risperidone, and safety of the combination of mood stabilizer and risperidone in the treatment of acute manic patients. Method : This study was performed as an open clinical study. The subjects of this study were 42 patients who had been admitted with first manifestations or acute exacerbations of illness were selected, using DSM-III-R criteria for bipolar disorder, manic episode. Patients were rated using the the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Extrapyramidal Symptom Rating Scale(ESRS). Other adverse events were assessed by a symptom checklist and by observation by medical personnel. Vital signs were monitored in a standard way and electrocardiography, routine laboratory analysis were performed. Results : Thirty patients(67%) completed the 12-week trial period. The CGI showed a good therapeutic effect with a minimal incidence or severity of side effects. The majority of patients showed a continuos reduction in their BPRS scores. The extrapyramidal symptoms assessed on ESRS generally showed mild to moderate degree. laboratory porameters showed no significant changes during the course of treatment. Conclusion : The results of the study showed a good efficacy of the risperidone in manic patients and further controlled studies are warranted.

• Journal of Pharmacopuncture
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• v.21 no.3
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• pp.185-194
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• 2018

Objectives: Vaginal Candidiasis with an approximate prevalence of 30% is the second cause of vaginal infections. Antifungal azole is the first treatment for Vaginal Candidiasis; however, some side effects have been reported for this chemical medicine. Based on the antifungal activity of Inner Stratum of Quercus Brantii (Q. Brantii), the aim of our study was to compare the effects of vaginal douche of Q. Brantii extract and clotrimazole on vaginal candidiasis symptoms before and after the treatments, in women. Methods: 89 non-pregnant women with positive KOH test which is capable of identifying the presence of hyphae and mycelium by adding KOH (10%), and a positive vaginal candidiasis culture were randomly divided into two experimental groups, using permuted block randomization method. One group received clotrimazole vaginal cream (1%) and the other group received vaginal douche of Q. Brantii extract. Groups were treated for 7 days and KOH tests and cultures were evaluated again. Data were analyzed via chi-square and independent t-test, using SPSS software. Results: According to the results, there were no significant differences between experimental groups for demographic characteristics like age (p=0.403), BMI (p=0.911), educational levels (p=0.862) and contraceptive methods (p=0.702). Moreover, significant differences were seen in vaginal discharge between the groups after the treatments (P=0.043). Conclusion: The results suggested that the therapeutic effect of vaginal douche of Q. Brantii extract was approximately similar to that of clotrimazole vaginal cream.

• BMB Reports
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• v.55 no.6
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• pp.293-298
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• 2022

Antipsychotics have been widely accepted as a treatment of choice for psychiatric illnesses such as schizophrenia. While atypical antipsychotics such as aripiprazole are not associated with obesity and diabetes, olanzapine is still widely used based on the anticipation that it is more effective in treating severe schizophrenia than aripiprazole, despite its metabolic side effects. To address metabolic problems, metformin is widely prescribed. Hypothalamic proopiomelanocortin (POMC) neurons have been identified as the main regulator of metabolism and energy expenditure. Although the relation between POMC neurons and metabolic disorders is well established, little is known about the effects of olanzapine and metformin on hypothalamic POMC neurons. In the present study, we investigated the effect of olanzapine and metformin on the hypothalamic POMC neurons in female mice. Olanzapine administration for 5 days significantly decreased Pomc mRNA expression, POMC neuron numbers, POMC projections, and induced leptin resistance before the onset of obesity. It was also observed that coadministration of metformin with olanzapine not only increased POMC neuron numbers and projections but also improved the leptin response of POMC neurons in the olanzapine-treated female mice. These findings suggest that olanzapine-induced hypothalamic POMC neuron abnormality and leptin resistance, which can be ameliorated by metformin administration, are the possible causes of subsequent hyperphagia.