• 생물정신의학
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• 제6권1호
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• pp.49-66
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• 1999

Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.

• 생물정신의학
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• 제5권1호
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• pp.56-65
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• 1998

Clinicians can use therapeutic drug monitoring(TDM) to optimise dosage decisions with psychotropic drugs, in order to maximize efficacy and prevent toxicity, especially when individuals are nonresponsive to treatment or vulnerable to adverse reactions with standard doses because age, disease states or drug interactions. Currently, therapeutic drug concentrations have been established for the TCA and lithium. There is also evidence for the usefulness of TDM with carbamazepine, valproic acid and some antipsychotic drugs. However for most psychotropic drugs this approach remains experimental. TDM-assisted psychiatric treatment is potentially useful and cost effective, particularly when applied by psychiatrists who are knowledgeable of pharmacokinetics and pharmacodynamics.

• Journal of Ginseng Research
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• 제14권2호
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• pp.171-177
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• 1990

Using an ethopharmacological technique, we demonstrated that saponin fraction from red ginseng root possessed a potent psychotropic actions on either intermale or maternal aggression models. A series of experiments clearly indicated that one of psychoactive ingredient is ginsenoside Rbl. Although a drug-induced debilitation of motor performance remains a possible cause of the antiaggressive affect of the drug. ginsenoside Rbl did not alter the locomotor activity of the mice during agonistic confrontations. Thus. one can eliminate the possibility that the psychotropic effect of ginsenoside Rbl might be concealed by a drug-induced impairment of motor performance. More recently, we developed a nevi model for copulatory disorder and introduced into the behavioral analysis of drug action. Male mice which has been housed individually from weaning for 5 weeks failed to manifest copulatory behavior when they encountered with the sexually receptive females. Daily administration of crude ginseng saponin during isolation housing period prevented the development of copulatory disorder, whereas both ginsenoside Rbl and Rgl were ineffective. A further experiment may be needed to explore active ingredient of ginseng saponins.

• 생물정신의학
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• 제5권1호
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• pp.46-55
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• 1998

Any compound which disrupts the integrity of psychological aspects of performance, in particular, cognitive ability and psychomotor function analogous to the psychological behaviors of routine life, is known to be behaviorally toxic. A significant level of behavioral toxicity will interfere with patient safety and quality of life, and also may be counter-therapeutic by exacerbating the condition that the drug was prescribed for. Now, behavioral toxicity of psychotropic drugs has become one of the main growth areas of psychopharmacological research. Evaluation of the potential of drug-induced behavioral toxicity is important not only to the experimental researcher involved in human psychopharmacology, but also to the clinical practitioner treating psychiatric patients. This article attempts to describe behavioral toxicity of the three classes of psychotropic drugs - benzodiazepines, antidepressants and neuroleptics. After a brief discussion of some methodological issues arising in the investigation of behavioral toxicity, each of these drug classes is reviewed in the context of practical importance rather than purely scientific concern. The last session summarizes some suggestions for future studies on drug-induced behavioral toxicity.

• 생물정신의학
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• 제3권2호
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• pp.149-155
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• 1996

Doctors who treat pregnant women ore usually cautious in writing their prescription for the drugs. The problem of which psychotropic medications ore sale during pregnancy seems to remain unsolved for many years. Although the rate of absorption is reduced due to a reduced rate of gastric emptying, the extent of absorption of drug is generally unchanged during pregnancy. Plasma volume and total body water increase during pregnancy. There is suggestion that drug metabolizing activity may be increased in pregnancy. Since the pregnancy increase the glomerular filtration rate significantly, drugs mainly eliminated by renal excretion will be cleared more quickly. Factors contributing to the potential teratogenecity of a drug include the type of compound, dose and duration of use, developmental stage of fetus at the time of exposure, and the effect of the drug on fetal pharmacokinetics. All major classes of psychotropic agents should be assumed to diffuse readily across the placenta to the fetus and to be present in some quantity in the breast milk. To decide when and how to start the drug treatment depends on an assessment of the risks related both with and without drug treatment of psychiatric disorders.

• 한국보건간호학회지
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• 제27권2호
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• pp.338-356
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• 2013

Purpose: This study critically reviewed nursing research psychotropic drugs that has been published in Korean journals. Another aim of this study was to identify trends in nursing research on psychotropic drugs and make suggestions for further study in Korea. Methods: Data were collected from degree theses and original articles on psychotropic drugs published in Korean journals from 1992 to 2013. Thirty-four articles were analyzed of which at least one nursing author participated in the study. Search keywords were "psychotropic drug" and "mentally ill patient & medication". Results: For the research design, quasi-experimental study was 58.8%, descriptive study was 17.7%, descriptive correlational study was 8.8%, qualitative study was 8.8% and model development research was 5.9%. Variables measured were knowledge of medication & symptom management, knowledge of disease, side effects, drug attitude, medication pattern, diet & activity, quality of life, and self-care. Conclusion: Despite recent increased interest in psychiatric medication, research on psychotropic drugs remains very limited, particularly regarding findings from a nurse's perspective. More research project should be designed to develop programs for the treatment of side effects from a nursing view-point.

• 고려인삼학회:학술대회논문집
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• 고려인삼학회 1990년도 Proceedings of International Symposium on Korean Ginseng, 1990, Seoul, Korea
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• pp.29-35
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• 1990

Using an ethopharmacological technique, we demonstrated that saponin fraction from red ginseng root possessed a potent psychotropic actions on either intermale or maternal aggression models. A series of experiments clearly indicated that one of psychoactive ingredient is ginsenoside Rbl. Although a drug-induced debilitation of motor performance remains a possible cause of the antiaggressive effect of the drug, ginsenoside Rb 1 did not alter the locomotor activity of the mice during agonistic confrontations. Thus, one can eliminate the possibility that the psychoactive effect of ginsenoside Rbl might be concealed by a drugindulced impairment of motor performance. More recently, we developed a new model for copulatory disorder and introduced into the behavioral analysis of drug action. Male mice which has been housed individually from weaning for 5 weeks failed to manifest copulatory behavior when they encountered with the sexually-receptive females. Daily administration of crude ginseng saponin during isolation housing period prevented the development of copulatory disorder, whereas both ginsenoside Rbl and Rgl were ineffective. A further experiment may be needed to explore active ingredient of ginseng saponins. Keywords Panax ginseng, Korean red ginseng, psychotropic action, saponin, ginsenoside Rb1

• 생물정신의학
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• 제3권2호
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• pp.156-161
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• 1996

Many pregnant women have to receive psychotropic medication during pregnancy and lactation period, despite the proven and assumed risks to the fetus ar neonate. A brief summary of drug metabolism and pharmacodynamics is given. Principles and quidelines of using psychotropic agents during pregancy and lactation period are presented for psychotic disorders, bipolar affective disorders. depression and anxiety disorders, with due consideration for relative benefits and risks of choosing among psychotropic drugs and alternative treatments.

• 정신신체의학
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• 제19권2호
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• pp.57-65
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• 2011

많은 심혈관질환약물과 향정신성약물 간에 다양한 약물상호작용이 존재하며 이러한 약물들의 대부분이 시트크롬(cytochrome, CYP)450 효소의 기질, 억제제, 유도제로 작용하면서 약물상호작용이 일어나게 된다. 주로 CYP2D6와 CYP3A4를 억제하는 향정신성약물로 인해 같이 투여되는 심혈관질환약물의 효과가 변할 수 있고 부작용까지 나타날 수 있다. 이런 상황을 고려하고 반대의 경우도 포함하여 흔히 처방되는 두 종류의 약물을 병용 투여하는 경우 고려해야 할 부분에 대해서 심혈관질환약물 분류에 따라 논하였다. 대부분의 베타차단제는 CYP2D6의 대사에 의존하므로 이 대사를 억제하는 bupropion, chlorpromazine, haloperidol, SSRIs, quinidine 등을 사용했을 때 베타차단제의 독성이 나타날 수 있다. 앤지오텐신 관련 약물과 이뇨제가 lithium의 농도를 변화시키는 점도 고려하여야 한다. 칼슘통로차단제 및 콜레스테롤강하제를 CYP3A4의 강력한 억제제인 amiodarone, diltiazem, fluvoxamine, nefazodone, verapamil 등과 함께 사용하였을 때 약물 상호작용에 따른 부작용에 유의하여야 한다. 항부정맥제를 복용하는 환자에서 QT 간격 증가를 야기하는 약물이나 관련 CYP450 효소를 억제하는 약물을 동시에 투여하는 것은 삼가거나 적극적인 관찰이 필요하다. Digoxin과 warfarin이 병용 투여되는 향정신성약물로 인해 혈중 농도가 변하는 것도 임상적으로 중요하다.

• Molecular & Cellular Toxicology
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• 제5권4호
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• pp.346-353
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• 2009

Drug metabolism is a critical determinant of the therapeutic and adverse effects of many psychotropic drugs. The metabolism depends on the pharmacokinetics of a drug, which includes its absorption, distribution, and elimination. Psychotropic drugs are metabolized mainly by cytochrome P450 (CYP) enzymes; about 20 of these enzymes exist and they are often responsible for the rate-limiting step of drug metabolism. CYP2D6 is the best-characterized P450 enzyme that exhibits polymorphism in humans. This study determined the relationship between the CYP2D6*10 (P34S) polymorphism and the response to mirtazapine in 153 Koreans with major depressive disorder (MDD). The genotype frequencies were compared using logistic regression analysis, and between-genotype differences in the decrease in the 21-item Hamilton Depression (HAMD21) score over the 12-week treatment period were analyzed using a linear regression analysis. The proportion of remitters was lower in patients with MDD possessing the S allele than in P allele carriers after 2 weeks of mirtazapine treatment. Similarly, the reductions in the HAMD21 and Clinical Global Impression (CGI) scores in S allele carriers were smaller than those in patients with the P allele after 2 weeks of mirtazapine treatment. In the analysis of depression symptoms, the sleep and delusion scores had smaller reductions in S allele carriers. Based on the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), the psychic adverse effects of mirtazapine were associated with CYP2D6 P34S, while weight gain was not. These results suggest that CYP2D6 P34S affects the outcome of mirtazapine treatment in patients with MDD, and that this polymorphism may be a good genetic marker for predicting the clinical outcome of mirtazapine treatment.