• 제목/요약/키워드: antipsychotics drug

검색결과 65건 처리시간 0.02초

Metformin ameliorates olanzapine-induced disturbances in POMC neuron number, axonal projection, and hypothalamic leptin resistance

  • Kim, Jaedeok;Lee, Nayoung;Suh, Sang Bum;Jang, Sooyeon;Kim, Saeha;Kim, Dong-Gyu;Park, Jong Kook;Lee, Keun-Wook;Choi, Soo Young;Lee, Chan Hee
    • BMB Reports
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    • 제55권6호
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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.

지연성 진전 1례 (A Case of Tardive Tremor as A Varient of Classic Tardive Dyskinesia)

  • 이장호;윤도준
    • 생물정신의학
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    • 제2권1호
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    • pp.140-143
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    • 1995
  • Tardive dyskinesia(TD), typically appearing as an undesirable side effect of a long term antipsychotic drug treatment has gained increased attention in recent times due to the discovery of many TD variants. This is a single case study of a patient who has undergone more than 8 years of high dosage antipsychotic treatment. After altering the type and dosage of antipsychotic medication 3 months prior to visit, the patient showed relatively abrupt onset symptoms of severe tremor and dystonia. These symptoms, appearing in clear consciousess, got better to a certain degree after 48 hours, worsened for 12 hours, and then improved again. Subsequently there was no continuing movement disorder. Several tests and consultation were carried out. However except for the medication factor, no other possible causes for such disabling symptoms were found. This clinical condition was thought to be akin to tardive tremor, a variant of TD. Furthermore, the course was atypical.

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정신분열병의 병태생리 및 치료영역에서의 serotonin의 역할 (Role of Serotonin in Pathophysiology and Treatment of Schizophrenia)

  • 박소영;한규희
    • 생물정신의학
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    • 제4권2호
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    • pp.162-167
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    • 1997
  • There is no doubt that dopamine plays a critical role in the etiopathogenesis of schizophrenia. However, there appeared some limitations in explaining the complex phenomena of schizophrenia. Recent research data suggest that dysfunction in serotonergic system may be involved. Before the dopamine hypothesis of schizophrenia became established, the interest in serotonin(5-hydroxytryptamine, 5-HT) as an etiological substrate of this illness occurred. Recently the importance and extent of 5-HT's involvement in the pathophysiology and mechanism of action of antipsychotic drug is actively investigated. In recent years, therapeutic success of clozapine and risperidones has increased attention on the interaction between the 5-HT and dopamine systems in schizophrenia. This led to the concept of serotonin-dopamine antagonist for antipsychotics. The authors review the evidence for the role of 5- HT in schizophrenia and serotonin-dopamine interaction.

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Quetiapine 치료 중 발생한 무증상 갑상선 기능저하증 1례 (Subclinical Hypothyroidism during Quetiapine Treatment : A Case Report)

  • 나경세;김용구
    • 생물정신의학
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    • 제14권1호
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    • pp.68-71
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    • 2007
  • Quetiapine is an atypical antipsychotic drug with a benign side effect profile. However, recent studies have reported that thyroid dysfunction is associated with quetiapine treatment. The authors report a patient with DSM-IV bipolar I disorder who developed subclinical hypothyroidism during quetiapine treatment. The patient showed no significant clinical symptoms, but only abnormal thyroid function test findings including antithyroglobulin antibody. The abnormal thyroid function test findings were normalized after discontinuation of quetiapine. The subclinical hypothyroidism developed during quetiapine treatment may be associated with autoimmune process.

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리스페리돈으로 인한 신경이완제 악성 증후군 1례 (A Case of Risperidone-induced Neuroleptic Malignant Syndrome)

  • 강화연;김용구;이민수
    • 생물정신의학
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    • 제5권1호
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    • pp.138-141
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    • 1998
  • Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics, characterized by muscular rigidity, fever, autonomic dysfunction, and altered consciousness. The major theories to explain NMS is central dopaminergic blockade, but it is unclear. Risperidone is a new antipsychotic drug, a benzisoxazole derivative that blocks dopamine $D_2$ receptor and serotonin type 2 receptor. The comparatively greater serotonin-blocking activity is believed to give risperidone the specific property of not causing any more extrapyramidal side effects than conventional antipsychotics at the optimal dose of 4-8mg/day. It is postulated that risperidone is unlikely to cause NMS. Here, we report a case of risperidone induced neuroleptic malignant syndrome.

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Antidepressant-induced Burning Mouth Syndrome - A Unique Case

  • Raghavan, Shubhasini Attavar;Puttaswamiah, Rajiv Nidasale;Birur, Praveen N.;Ramaswamy, Bhanushree;Sunny, Sumsum P.
    • The Korean Journal of Pain
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    • 제27권3호
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    • pp.294-296
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    • 2014
  • Burning Mouth Syndrome (BMS) is defined as a chronic orofacial pain syndrome, without evidence of mucosal lesions and other clinical signs of disease or laboratory abnormalities. Patients with BMS complain of burning pain in the mouth, xerostomia and taste disturbances. It is more common among women and the median age of occurrence is about 60 years. BMS may be primary or secondary to other diseases. The mainstay in the treatment of BMS includes antidepressants, benzodiazepines, and anticonvulsants. A few cases of BMS caused due to medication have been reported. The causative drugs include angiotensin-converting enzyme inhibitors, anticoagulants, antipsychotics, antiretrovirals, and benzodiazepines. This is a case report of a patient on antidepressants who developed symptoms of BMS thereby causing a dilemma in management.

치료저항성 조현병에서 클로자핀 치료의 현황 (Current Status of Clozapine for Treatment-Resistant Schizophrenia)

  • 김세현
    • 대한조현병학회지
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    • 제24권1호
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    • pp.1-7
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    • 2021
  • Clozapine is the first and most effective atypical antipsychotic drug for treatment-resistant schizophrenia (TRS). After withdrawal of clozapine due to concerns of agranulocytosis, clozapine was reintroduced with a comprehensive safety monitoring system, the clozapine patient monitoring system (CPMS). The reintroduction was a response to the pressure from psychiatrists and patients with TRS and their families. Clozapine is still the best single agent for the treatment of TRS. However, approximately 30% of patients with TRS still show psychotic symptoms. In patients with clozapine-resistant schizophrenia (CRS), augmentation of other antipsychotic agents could be considered after a thorough evaluation of proper clozapine treatment. In this review, the status of clozapine in patients with TRS and CRS will be discussed.

치료 위저항성 조현병: 치료 비순응을 중심으로 (Pseudo-Resistant Schizophrenia: Non-Adherence to Treatment)

  • 김혜림;이승재
    • 대한조현병학회지
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    • 제23권2호
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    • pp.51-57
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    • 2020
  • Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to exclude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacokinetic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or pharmacokinetic factors, and present methods to enhance drug adherence.

만성 정신분열병 환자에서 Risperidone과 Clozapine이 체중과 혈당에 미치는 영향 - Haloperidol과의 비교 연구 - (The Influences of Risperidone and Clozapine on Body Weight and Glucose Level in Patients with Chronic Schizophrenia - Comparison Study with Haloperidol -)

  • 남천우;양병환;이준노
    • 생물정신의학
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    • 제11권2호
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    • pp.127-135
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    • 2004
  • 본 연구는 비전형적 항정신병약물이 체중과 혈당에 미치는 영향을 알아보고 그에 관계되는 여러 변인들의 관련성을 알아보고자 하였으며 이를 위해 비전형적 항정신병약물인 risperidone과 clozapine을 쓰는 환자 각각 20명, 대조군으로 전형적 항정신병약물인 haloperidol을 쓰는 환자 20명을 대상으로 입원 후 4주, 8주, 12주째 체중과 공복 시 혈당을 입원 초기 체중 및 혈당과 비교하였으며 각 약물군 간의 차이를 조사하여 다음과 같은 결과를 얻었다. 첫째, 연구 대상 환자의 초기 특성 상 clozapine군이 haloperidol과 risperidone군에 비하여 입원 시 체중이 높은 상태였는데 이는 clozapine을 복용하는 환자들이 이전에 haloperidol과 risperidone을 포함한 여러 가지 항정신병약물을 복용했던 경험이 있고 이로 인해 이미 어느 정도의 체중 증가가 있었던 것으로 생각해볼 수 있다. 둘째, 체중 변화는 risperidone과 clozapine군 모두 haloperidol을 쓴 군과 유의한 차이가 없었다. 셋째, 혈당 변화도 비전형적 항정신병약물인 risperidone과 clozapine군이 haloperidol군에 비해 의미 있는 차이가 없었다. 넷째, 몇 가지 변수들이 체중과 혈당의 변화에 연관성을 가지고 있었으나 그 정도는 크지 않았고 그 인과관계를 증명할 수는 없었다. 위의 결과들에서 볼 때 유병 기간이 길고 이전에 여러가지 항정신병약물을 복용한 경험이 있는 환자, 약물 복용에 따른 증상의 호전 정도가 두드러지지 않는 만성적인 정신분열병 환자들에서는 비전형적 항정신병약물이 전형적 항정신병약물에 비해 체중 변화와 혈당의 수치를 변화시키는 경향이 크지 않다는 점을 알 수 있었다.

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향정신성 약물 중독에 의한 QTc 연장과 그 위험성에 대한 고찰 (QTc Prolongation due to Psychotropic Drugs Intoxication and Its Risk Assessment)

  • 박관호;홍훈표;이종석;정기영;고석훈;김성규;최한성
    • 대한임상독성학회지
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    • 제18권2호
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    • pp.66-77
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    • 2020
  • Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual's risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients. The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion: Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.