• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권2호
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• pp.72-82
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• 2008

The aim of this paper is to evaluate the use of non-stimulants, including atomoxetine, bupropion and modafinil, as alternative approaches to the treatment of children with attention-deficit hyperactivity disorder. A comprehensive review of the empirically based literature regarding the efficacy and the safety of the non-stimulants was performed. There is a large and increasing body of data supporting the efficacy and the safety of non-stimulants. Although the treatment effect sizes for non-stimulants may be smaller than those for stimulants, non-stimulants alone have been shown to be effective in the treatment of attention-deficit hyperactivity disorder as well as several comorbidities. These results suggest that non-stimulants are effective in the treatment of attention-deficit hyperactivity disorder. Further studies are needed to improve our understanding of alternative pharmacological medications in the treatment of attention-deficit hyperactivity disorder.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제33권2호
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• pp.27-34
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• 2022

Stimulants, such as amphetamine and methylphenidate, are one of the most effective treatment modalities for attention deficit hyperactivity disorder (ADHD) and may cause various movement disorders. This review discusses various movement disorders related to stimulant use in the treatment of ADHD. We reviewed the current knowledge on various movement disorders that may be related to the therapeutic use of stimulants in patients with ADHD. Recent findings suggest that the use of stimulants and the onset/aggravation of tics are more likely to be coincidental. In rare cases, stimulants may cause stereotypies, chorea, and dyskinesia, in addition to tics. Some epidemiological studies have suggested that stimulants used for the treatment of ADHD may cause Parkinson's disease (PD) after adulthood. However, there is still a lack of evidence that the use of stimulants in patients with ADHD may cause PD, and related studies are only in the early stages. As stimulants are one of the most commonly used medications in children and adolescents, close observations and studies are necessary to assess the effects of stimulants on various movement disorders, including tic disorders and Parkinson's disease.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권2호
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• pp.61-71
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• 2008

Attention-deficit hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, impulsiveness and problems in other higher cognitive processes such as executive function deficits. Currently, there are many treatment modalities, of which pharmacotherapy is the most strongly supported by scientific and clinical evidence. Stimulants, which are first choice in the pharmacological treatment of ADHD, block dopamine reuptake by binding the dopamine transporter and so increasing the concentration of dopamine in synaptic clefts. Stimulants are effective in improving core ADHD symptoms, as well as the nonspecific symptoms, such as aggressiveness and oppositional behavior. Frequently reported short-term adverse effects are decreased appetite, sleep disturbance, headache, dizziness and irritability. Although questions have been raised about the long-term side effects of stimulants, including growth suppression, cardiovascular events, and abuse potential, there is no clear evidence to support these concerns.

• Mass Spectrometry Letters
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• 제10권1호
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• pp.1-10
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• 2019

Amphetamine-type stimulants (ATS) are a group of ${\beta}$-phenethylamine derivatives that produce central nervous system stimulants effects. The representative ATS are methamphetamine and 3, 4-methylenedioxymethamphetamine (MDMA), and abuse of ATS has become a global problem. Methamphetamine is abused in North America and Asia, while amphetamine and 3, 4-methyle nedioxym ethamphetamine (Ecstasy) are abused in Europe and Australia. Methamphetamine is also the most abused drug in Korea. In addition to the conventional ATS, new psychoactive substances (NPS) including phenethylamines and synthetic cathinones, which have similar effects and chemical structure to ATS, continue to spread to the global market since 2009, and more than 739 NPS have been identified. For the analysis of ATS, two tests that have different theoretical principles have to be conducted, and screening tests by immunoassay and confirmatory tests using GC/MS or LC/MS are the global standard methods. As most ATS have a chiral center, enantiomer separation is an important point in forensic analysis, and it can be conducted using chiral derivatization reagents or chiral columns. In order to respond to the growing drug crime, it is necessary to develop a fast and efficient analytical method.

• 대한약리학회지
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• 제3권1호
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• pp.15-18
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• 1967

Sympathetic ganglionic stimulants (DMPP, Wy-615, TMA and McN-A-343) produced pressor response in chickens anesthetized with phenobarbital sodium. In adrenalectomized chickens the pressor activity of DMPP, Wy -615 and TMA was less than in normal chickens but that of McN-A-343 was unchanged. Hexamethonium (20 mg/kg) and chlorisondamine (5 mg/kg), ganglionic blocking agents, reduced the pressor response to DMPP and Wy-615 but did not abolish the response. The pressor effect of McN-A-343 was not potentiated by the ganglionic flocking agents, but abolished by atropine.

• 대한약리학회지
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• 제12권1호
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• pp.15-22
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• 1976

The clinical abuse of C.N.S. stimulants during recent years has directed particular attention. Effect of various organs other than C.N.S. was also extensively investigated with those agents. It has been shown that, although there is a wide variation in sensitivity between species, caffeine stimulates gastric secretion in man, cat, guinea pig and dog. Roth and Ivy(1944) reported that caffeine and histamine acted synergistically in stimulating gastric secretion in the cat. Vaille et al(1966) studied that production of pancreatic juice in the rat was enhanced, but bile secretion was not affected by caffeine. In clinical study the effect of chlorpromazine on the external pancreatic secretion in the 24 subjects, the volume fell more than 20% in 7 subjects. (Skajaa et al 1960) It is widely known that C.N.S. stimulants enhanced spontaneous motor activity in the mice, while tranquilizers depressed the activity. Woo (1975) reported that the group of mice treated with chlorpromazine showed markedly inhibited motor activity and in the group of mice treated with amphetamine, there was a significant increase in the motor activity. The purpose of the present experiment was to study the effects of C.N.S. stimulants and depressant on the exocrine pancreas, and on the spontaneous motor activity in the rats. The results obtained are summarized as follows. 1. In animals treated with xanthine derivatives, the volume of pancreatobiliary secretion was markedly increased. 2. Total bilirubin output was elevated markedly in the xanthine derivatives and imipramine treated animals. The bilirubin concentration was increased in xanthine derivatives treated group. 3. The concentration of cholate in the bile was decreased in the chlorpromazine treated group. 4. The activity of lipase in the pancreatobiliary juice was elevated markedly in the xanthine derivatives treated group only. 5. In the all experimental groups, the activity of amylase in pancreatobiliary juice was significantly elevated. 6. In the caffeine treated group, spontaneous motor activity was markedly increased in $30{\sim}60$ minutes, and the amphetamine treated group showed the increased motor activity in first 30 minutes. 7. The group of rats treated with chlorpromazine showed markedly inhibited motor activity after 30 minutes, and the imipramine treated group showed similar result but less inhibition.

• 한국임상약학회지
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• 제28권3호
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• pp.216-223
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• 2018

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제1권1호
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• pp.77-88
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• 1990

주의력 결핍장애아동의 치료는 악물치료가 중요하지만 중복장애아동과 같은 원칙에서 인지-행동적, 교육적 접근과 상호보완이 필요하다. 치료의 첫단계는 진단을 확립하고, 아동, 부모, 교사에게 이장애의 특성을 설명해 주고 치료의 대책을 세운다. 약물치료는 주로 중추신경자극제-그중에서도 메칠페니데이트를 중심으로 논의하였고, 그외에 삼환계 항우울제, 클로니딘, 항정신병약물이 소개되었다. 약물치료이외의 방법들로는 정신요법, 인지행동요법, 교육적 방법과 부모및 가족상담의 원칙들을 논의하였다. 이들 전통적인 치료방법이외에 논란되고 있는 식이요법, 비타민요법, 저당분요법, 미네랄요법, 정제된 당분의 투여, 신경학적 조직의 이론에 근거한 운동요법들을 소개하고 설명하였다.

• 대한간호학회지
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• 제35권7호
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• pp.1401-1409
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• 2005

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

• 대한약리학회지
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• 제3권1호
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• pp.5-13
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• 1967

It has been reported by some investigators that pressor response of rabbits to sympathetic ganglionic stimulants was weak. In this paper it was attempted to investigate this problem more thorouglhy in urethane anesthetized rabbits. 1) In rabbits the approximate doses to elicit increase of about 20 mmHg of blood pressure were $100\;{\mu}g/kg$ with DMPP, $50\;{\mu}g/kg$ with Wy-615, $500\;{\mu}g/kg$ with TMA and with nicotine. The pressor activity of these substances was markedly augmented by treating animals with syrosingopine. 2) In adrenal-ligated rabbits pressor activity of the substances was markedly reduced. Treating the adrenal-ligated animals with syrosingopine augmented significantly the pressor activity of these substances except DMPP. Direct injection of DMPP and TMA into the adrenal produced mole pressor response than intravenous injection did. These date suggest that DMPP has greater effect on the adrenal medulla than the other substances. 3) In vagotomized and atropinized rabbits the pressor activity of these compounds was more marked than in normal rabbits. 4) The above facts indicate that the pressor activity of the ganglionic stimulants in rabbits was definitely low than in cats and dogs. The low responsiveness of the rabbits to these agents was discussed in the light of catecholamine releasing mechanisms, and extraganglionic actions of these substances.