• 정신신체의학
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• 제3권1호
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• pp.72-80
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• 1995

Because the origins of stress are various, complex, and often indirectly-causing, reactions to stress are also various according to it's psychopathologies and mechanisms. For a proper management of stress, first of all accurate evaluation and diagnosis must be done. Then, treatment against the stress also can be considered, if necessary. In case of extreme stress, psychotropic drugs such as short-term anxiolytics or antidepressants can be used according to it's specific target symtoms. But long-term treatment of stress must be directed by increasing the individual's usual coping strategy or decreasing the externally causing stresses. Reactions to stress and drug interactions. which are not the whole of the biologic treatment strategy, are very important As a results, in our discussions, we ought to describe the issues by focusing the interactions between the drug and it's reaction to stress rather than the reaction to stress or drug itself and aimed at helping the proper treatment against the stress.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권2호
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• pp.83-88
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• 2008

Antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), are one of the most commonly used classes of psychotropic drugs for treating children and adolescents. The US Food and Drug Administration has issued a black box warning concerning the increased risks of suicidal ideation and behavior associated with antidepressant treatment in children and adolescents. The aim of this review is to assess the risks and benefits of antidepressants in the treatment of child and adolescent psychiatric disorders.

• The Korean Journal of Pain
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• 제8권2호
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• pp.354-356
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• 1995

Rectal tenesmus is a persistent, painful and ineffectual sensation of straining at stool or opening of the bowels. Lumbar sympathectomy was performed in patient whose main complaint was rectal tenesmoid pain resulting from hemorrhoid operation, and in whom analgesic or psychotropic drugs had failed in controlling the symptom. After chemical lumbar sympathectomy, patient was free from the rectal tenesmoid pain. It is concluded that lumbar sympathectomy is a safe and effective treatment for rectal tenesmus.

• Archives of Pharmacal Research
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• 제22권3호
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• pp.262-266
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• 1999

Dopamine transporter (DAT) plays the most important role in terminating the actions of dopamines released into the synaptic cleft. DAT is also the target of various psychotropic drugs such as cocaine and amphetamine. In this study were prepared DAT-specific antibodies using the 2nd extracellular loop of rat DAT as an antigen. The 2nd extracellular loop of the rat DAT was expressed in bacterial as a fusion protein with glutathione-S-transferase, and injected ito rabbits to raise antibodies. Produced antibodies clearly recognized the rat DAT in ELISA, immunoblotting, and immumoprecipitation. As expected from the high sequence homology between the rat and human DAT, the antibodies raised for the rat DAT cross-reacted with the human DAT in the immunoblotting. Considering the specificity for DAT with wide range of applications such as ELISA, immunoblotting, and immunoprecipitation, these antibodies would be valuable tool for understanding the pharmacological actions of dopamine transporter and drug addition.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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• pp.111.2-112
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• 2003

Dextromethophan and carisoprodol have been abused to obtain a hallucination for longer than 10 years in Korea. Due to their seriousness of abuse liablility, recently government decided to control them as a psychotropic agents. As these are controlled, it is necessary for us to establish the analysis of these medicine and their metabolites in hair to prove the abuse of these drugs. This study is described for the determination of dextrometorphan and carisoprodol in hair. (omitted)

• Journal of Ginseng Research
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• 제17권3호
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• pp.187-195
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• 1993

We have examined the functional role of central dopaminergic processes on the behavioral pharmacological effects induced by psychotropics and red ginseng saponins of normal rats and compared with that of brain damaged rats. Desipramine and clomipramine produced, a significant depression of the locomotor activity in normal rats, but in brain damaged rats, they did not have any effect throughout the experimental period of 4 hours. Total saponin (50~200 mg/kg), PT (25~50 mg/kg), PD (25~50 mg/kg), $Rg_1$(12.5~25 mg/kg), $Rb_1$ (12.5~50 mg/kg) did not change, and high concentrations of PT (100 mg/kg), PD (100 mg/kg) and $Rg_1$ (50 mg/kg) showed a significant decrease in the locomotor activity of one hour after administration but total saponin (100 mg/kg), PD (25~50 mg/kg), Rgl (12.5 mg/kg), $Rb_1$ (12.5 mg/kg) markedly increased the locomotor activity of four hour after administration in normal rats. On the other hand, total saponin (50 mg/kg), PT (100 mg/kg) and PD (100 mg/kg) Produced a prominent stimulation of the locomotor activity in brain damaged rats. These results suggest that the inhibition of the locomotor activity induced by antidepressants was not affected by the sensitivity of cerebral DA system, whereas red ginseng saponin showed antifatigue effect and also the stimulation of the locomotor activity induced by red ginseng saponin was mediated by the inhibition of cerebral DA system. These psychotropic action of red ginseng saponins could be responsible for the beneficial effects on conditions of fatigue and decreased alertness.

• 정신신체의학
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• 제7권2호
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• pp.256-262
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• 1999

만성 통증은 신체적, 심리적, 사회환경적 요인들이 복합적으로 작용한 결과로서 나타나기 때문에 생물정신사회적 관점에서 접근해야 하며 치료는 다각적이고 포괄적인 체제하에서 상호 긴밀한 협력을 필요로 한다. 치료의 목표는 즉각적인 통증의 해소보다는 재활에 초점을 맞추어 환자의 활동과 기능이 증진됨에 따라 부수적으로 통증이 완화될 수 있도록 해야 할 것이다. 정신과적 영역에서 만성 통증의 치료는 정신의학적 평가로부터 시작하는데 여기에는 스트레스와 연관된 통증의 정신생리적 기전과 이상 질병행동과 관련된 조작적 조건화 기전, 그리고 증상으로서 통증을 동반하거나 만성 통증에 의해서 유발되는 정신과적 질환들에 대한 평가가 포함된다. 정신과적 치료를 약물치료와 심리적 치료로 나눌 때 약물치료에는 마약성 진통제, 비스테로이드성 소염제, 향정신성약물, 항경련제 들이 포함되는데 그 중에서도 항우울제가 가장 중요한 역할을 한다. 심리적 치료로는 역동적 정신치료와 행동치료적 방법들이 있고 행동치료적 접근법에는 자가조절기법과 조작적 조건화기법 등이 포함되는데, 환자가 갖는 대인관계의 어려움, 신체적 손상, 이상 질병행동 등을 고려하여 적절한 방법을 적용하게 된다.

• 한국융합학회논문지
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• 제9권12호
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• pp.207-216
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• 2018

한국은 지적장애인에 대한 항정신약의 사용 실태를 국가적으로 조사한 연구가 없어 항정신약 사용의 문제점이나 개선사항을 파악하기 어렵다. 따라서 본 연구의 목적은 지적장애인에게 처방되는 항정신약의 사용 실태를 국가적으로 조사한 일본의 동향을 분석하여 한국에서의 조사를 위한 기초 자료를 제공하고자 한다. 연구 방법은 일본의 J-STAGE, 메디칼온라인, 코호트 연구에서 정신박약, 정신지체, 지적장애, Psychotropic, Antipsychotic, 행동장애로 검색하여 유효한 논문들을 비교 분석하였다. 연구 결과는 첫째, 지적장애인에게 처방되는 다양한 항정신약물의 치료 효과에 대한 정확한 평가가 곤란하며, 둘째, 부작용을 쉽게 알아내지 못하는 동향이 높으며 셋째, 약물 간의 상호작용에 의한 부작용의 가능성에 대한 문제가 제기되고 있음을 알 수 있었다. 이 결과는 향후 한국의 지적장애인에게 보다 안전한 항정신약의 사용을 보장하기 위한 연구와 조사는 물론 개선 방법을 모색하는데 기초 자료가 될 것이다.

• 생물정신의학
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• 제4권2호
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• pp.198-210
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• 1997

To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

• 생물정신의학
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• 제6권2호
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• pp.253-258
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• 1999

The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.