• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.44-51
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• 2003

Objectives: Antidepressants are frequently associated with sexual dysfunction. Especially, there were few report of sexual dysfunction related with venlafaxine and mirtazapine in Korea. The purpose of this survey was to evaluate the frequency and nature of sexual dysfunction related with selective serotonin reuptake inhibitors(SSRIs), venlafaxine and mirtazapine by the use of specific questionaires. Methods: In one hundred twenty two patients, sexual dysfunction was investigated cross-sectionally by using The questionaires for sexual dysfunction, which includes questions about decreased libido, delayed orgasm or ejaculation, premature ejaculation or orgasm, absence of orgasm or ejaculation, erectile dysfunction in men/vaginal lubrication dysfunction in women, sexual pain and patient's tolerance of the sexual dysfunction. BDI was also measured. Sexual dysfunction was analyzed in association with the duration and the dose of medications and the severity of depression. Results: The incidence of sexual dysfunction during antidepressants use in our survey was 37.7%. There were no difference of incidence in sexes(p=.746). In comparison of paroxetine, venlafaxine and mirtazapine, there were no significant differences of the incidence(p=.065) and the severity of any type of sexual dysfunction. Conclusion: Although there were no significant differences of sexual dysfunction in our survey, sexual dysfunction may be closely associated with antidepressants. Further prospective study of sexual dysfunction should be needed.

• Proceedings of the PSK Conference
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• 2003.10b
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• pp.121.3-122
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• 2003

This report describes the fatal case of a 13-year-old middle school girl(MSG) whose cause of death might be attributed to a intoxication involving Venlafaxine(VEN). MSG's mother had the history of depression for 11 years. She and her daughter were found dead in the same room of their apartment, with hanged herself. We analyzed the postmortem of MSG which were requested to our institute for the cause of her death. We couldn't get any blood samples from MSG's postmortem. (omitted)

• Polymer(Korea)
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• v.36 no.3
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• pp.332-337
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• 2012

The primary objective of this work is to find the properties of sustained release dissolution pattern depending on solubility of drugs, so venlafaxine HCl and carbamazepine tablets were made by using polymer wich various particle size. Hydroxy propyl methyl cellulose (HPMC) has been utilized in this study as an excipient that is one of the most widely used polymers for an oral sustained release formulation, and drug release pattern was strongly influenced by swelling rate depending on particle size of HPMC. Scanning electron microscope (SEM) was employed to investigate the surface of tablets with various HPMC particle size, and differential scanning calorimeter (DSC) was employed to investigate the crystallization of drugs in tablets. The release model equation was applied to analyze the main mechanism of drug release pattern. The results demonstrate that drug release pattern is controlled by the drug solubility and HPMC particle size.

• Journal of Pharmaceutical Investigation
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• v.37 no.6
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• pp.397-402
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• 2007

To evaluate the bioequivalence of two venlafaxine formulations, a standard 2-way randomized cross-over study was conducted in twenty-four healthy male Korean volunteers. A single oral dose of 75 mg of test formulation Venfaxine $OR^{(R)}$ (tablet) or reference formulation Efexor $XR^{(R)}$ (capsule) was administered with one-week washout period. Plasma concentrations of venlafaxine were assayed for over a period of 72 hours with a well validated method using liquid chromatography coupled to tandem mass spectrometry (LC-MS-MS). The $mean{\pm}S.D$. of maximum concentration $(C_{max})$ and elimination half-life $(t_{1/2})$ were $64.7{\pm}28.5$ ng/mL, $9.2{\pm}3.0$ h, and $67.2{\pm}30.2$ ng/mL, $9.9{\pm}3.5$ h for test and reference formulations, respectively. Time to reach maximum concentration $(T_{max})$ expressed in median value (range), for the test and the reference, were 10 h (6-14) and 8h (4-12), respectively. Similarly, area under the plasma concentration-time curve, from time zero to last sampling time $(AUC_t)$ and from time zero to time infinity $(AUC_{inf})$, for test and reference formulations were $1185{\pm}755$, $1326{\pm}896$ and $1124{\pm}737$, $1185{\pm}755$ $ng{\cdot}h/mL$, respectively. The parametric 90% confidence intervals on the mean of the differences between the two formulations (test-reference) of the log transformed values of $AUC_t$, and $C_{max}$ were 0.9630 to 1.1383 and 0.8650 to 1.0446, respectively. The overall results indicate that the two formulations are bioequivalent and can be prescribe interchangeably.

• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.34-40
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• 1999

New antidepressants have become available for clinical use in the 1990s. Before this decade, the drugs available to treat depression consisted essentially of monoamine oxidase inhibitors, tricyclic antidepressants, and lithium. Following the introduction of SSRIs, the options have expanded and now include SSRIs, nefazodone, venlafaxine, mirtazapine, reboxetine, tianeptine. Newer antidepressants possess a variety of pharmacological characteristics that are relevant to the choice of an antidepressant for clinical use. This review summarizes some of the major pharmacological characteristics among the drugs.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.274-280
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• 1999

A variety of mechanism may generate pain resulting from injury to the central and peripheral nervous system. None of these mechanism is disease-specific, and several different pain mechanism may be simultaneously present in anyone patient, independent of diagnosis. Diagnosis of neuropathic pain is often easily made from information gathered on neurologic examination and from patient history. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if the neurologist has a complete understanding of therapeutic options, the mainstay of which is pharmacotherapy. Selection of an appropriate rharmacologic agent is by trial and error since individual responses to different agents, doses, and serum levels are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuropathic pain. Tricyclic antidepressants are first-line agents, although other drugs, including anticonvulsants, local anesthetic antiarrhythmics, clonidine, opiates, and certain topical agents, also offer pain relief in some patient populations. The novel antidepressants venlafaxine and nefazodone are potentially useful new drugs that are better tolerated than tricyclic antidepressants. Also Gabapentine seems an interesting and promising drug for the treatment of neuropathic pain.

• Sleep Medicine and Psychophysiology
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• v.17 no.2
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• pp.63-68
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• 2010

Narcolepsy is a central neurologic system disease. It begins early in life with disabling symptoms including excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucination and nocturnal sleep fragmentation. Patient with typical symptoms of narcolepsy is diagnosed by objective data from nocturnal polysomnography and multiple sleep latency tests. Narcolepsy is controlled with various medications. Nowadays, modafinil with favorable side effects profiles compared with traditional stimulant is mainly used. Gamma hydroxyl butyrate is effective in cataplexy. Cataplexy is also controlled with antidepressant such as Venlafaxine, SSRI, and TCA. As the knowledge of pathophysiology of narcolepsy expands, new treatment including immunological method, application of hypocretin and histamine systems have been tried.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.2
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• pp.111-132
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• 2001

Depression in the medically ill is a common clinical problem that primary physicians and psychiatric consultants encounter. Treatment of such patients begins with a careful evaluation of the patient's medical and psychiatric conditions. The assessment of depression in the medical patients requires a multidimensional approach. Psychological instruments are also used as a method of assessment in these patients. First of all, what the therapists have to do is to find and remove organic causes. Psychosoical treatment includes dealing with the patient's resistance and despondency relevant to physical diseases. For biological treatment, it is important to select appropriate antidepressants. Therapists should be familiar with the side effects of the antidepressants as well as the patient's primary depressive symptoms, pharmacokinetics and pharmacodynamics of the available agents. In addition, special attention should be paid to the potential for drug-illness and drug-drug interactions. Tricyclic antidepressants can be still effectively used for patients with pain disorder, although a variety of new antidepressants such as selective serotonin reuptake inhibitors (SSRI), bupropion and venlafaxine could have more benefits in depression of the medically ill. However, electroconvulsive therapy can be recommended for refractory cases of depression in patients with medical illness.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.81-92
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• 2013

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.80-98
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• 2022

Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.