• Title/Summary/Keyword: serotonin syndrome

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Co-administration of Paroxetine and Haloperidol : Changes of Symptoms and Blood Level of Haloperidol, Reduced Haloperidol (만성 정신분열증 환자에서 Paroxetine과 Haloperidol 병합투여시 정신병리증상과 Haloperidol, Reduced Haloperidol 혈중농도의 변화)

  • Han, Chang Su;Lee, Min Soo;Kim, Pyo Han
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.251-257
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    • 1996
  • Selective serotonin reuptake inhibitors(SSRIs), as haloperidol, ore metabolized in the cytochrome P450IID6. They can cause inhibition of metabolism of antipsychotics to elevate the serum level of antipsychotics and exacerbate the extrapyramidal symptoms when co-administered with antipsychotics. Among these SSRIs, there ore a few studies about paroxetine compared to fluoxetine or sertraline. In this study, we have intended to know the drug interaction of paroxetine and haloperidol when co-administered two drugs for the chronic schizophrenics by assessing the changes of positive, negative symptoms and extrapyramidal symptoms. for this purpose, we selected 29 subjects, the chronic schizophrenics with no physical problems. They were under maintenance therapy of haloperidol. They ore randomly assigned to placebo group(n=12) and drug group(n=17) by using double blind method. And then, placebo or paroxetine 20mg were administered to the subjects of each groups during 8 week period. We have assessed their psychopathology and extrapyramidal symptoms using Positive and Negative Syndrome Scale(PANSS), Hamilton Rating Scale lor Depression(HRSD), Simpson-Angus Scale at 0, 2, 4, 6, 8 weeks and serum haloperidol, reduced haloperidol levels at 0, 4, 8 weeks during the period. The results ore analysed by using repeated measure MANOVA. 27 subjects have completed the study during 8 weeks. among the subjects, 1) PANSS, HRSD ; no significant difference between groups. 2) Simpson-Angus Scale ; no significant change according to the time and no significant difference between the groups(no group and time effect). 3) Haloperidol and reduced haloperidol level ; no significant change. When co-administered paroxetine and haloperidol, there ore no significant changes of the psychopothology and no significant changes of the extrapyramidal symptoms. In this result, paroxetine seems to be not to affect the metabolism of haloperidol.

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Study on the Anti-inflammatory, Analgesic and Anti-thrombotic Effects of Shintongchugeotang in the Experimental Animals (신통축어탕(身痛逐瘀湯)의 항염(抗炎), 진통(鎭痛) 및 항열전효과(抗血栓效果)에 관(關)한 연구(硏究))

  • Liu, Ji-Yong;Lee, Gi-Sang;Moon, Byung-Soon
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.69-85
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    • 1997
  • This study was designed to elucidate the anti-inflammatory, cardiovascular, anti-thrombotic and analgesic effects of Shintongchugeotang. The anti-inflammatory effect was measured by the method of carragenin induced edema, protein leakage test using CMC-pouch, and the analgesic effect was measured by the acetic acid method and hot plate method, and the effect of Shintongchugeotang on the cardiovascular system was observed by the change of flow rate of Ringer solution in the vascular system in the ear of rabbit, and the contraction and dilatation of rat tail artery. Death rate, platelet aggregation, plasma coagulation activity was observed for the measurement of the anti-coagurative effect of Shintongchugeotang. The result was as follows : 1. After the administration of Shintongchugeotang extract, Carragenin induced edema and CMC-pouch protein leakage were significantly decreased. 2. The slight analgesic effect of Shintongchugeotang extract was confirmed by the observation of writhing syndrome, paw licking time, and escape time. 3. The drug increased the auricular blood flow in rabbit. 4. The drug relaxed the artery contraction by pretreated norepinephrine in rat. 5. The drug inhibited the death rate of mouse which was led to thromboembolism by serotonin and collagen. 6. The drug inhibited the platelet aggregation in rat. 7. The drug prolonged the prothrombin time and activated partial thromboplastin time on the test of plasma coagulation factor activity in rat, but was not valuable.

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Effect of Duloxetine in Functional Gastrointestinal Disorder : In the Perspective of 'Brain-Gut Axis' (기능성 위장관 장애에서 Duloxetine의 효과 : '뇌-장관 축' 모델을 중심으로)

  • Lee, Sang-Shin;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.135-138
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    • 2012
  • The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).

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Study on the Antiinflammatory, Anticoagulative and Analgesic effects of Sambitang in the experimental animal model (삼비탕(三痺湯)의 항염(抗炎), 항응고(抗凝固) 및 진통효과(鎭痛效果)에 대(對)한 연구(硏究))

  • Rhy, Jun-Kiu;Lee, Young-Goo;Moon, Byung-Soon
    • The Journal of Internal Korean Medicine
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    • v.19 no.2
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    • pp.88-106
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    • 1998
  • This study was designed to elucidate the antiinflammatory, cardiovascular, antithrombotic, and analgesic effect of Sambitang. The antiinflammatory effects was measured by the method of carrageenin induced edema, protein leakage test using CMC-pouch, and the effect of Sambitang on the cardiovascular system was observed by the change of flow rate of Ringer solution in the vascular system in the ear of rabbit, and the contraction and dilatation of rat tail artery. Death rate, platelet aggregation, plasma coagulation activity was observed for the measurement of the anticoagurative effect of Sambitang, and the analgesic effect was measured by the acetic acid method and hot plate method. The result was as follows: 1. Sambitang administration, edema and protein leakage was significantly decreased. 2. The drug increased the auricular blood flow in rabbit. 3. The drug relaxed the artery contraction by pretreated norepinephrine in rat. 4. The drug inhibited the death rate of mouse which was led to thromboembo- lism by serotonin and collagen. 5. The drug inhibited the platelet aggregation in rat. 6. The drug prolonged the prothrombin time and activated partial thromboplastin time on the test of plasma coagulation factor activity in rat, but was not valuable. 7. The slight anagesic effect of Sambitang extract was confirmed by the observation of writhing syndrome, paw licking time, and escape time.

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Effects of Paroxetine on a Human Ether-a-go-go-related Gene (hERG) K+ Channel Expressed in Xenopus Oocytes and on Cardiac Action Potential

  • Hong, Hee-Kyung;Hwang, Soobeen;Jo, Su-Hyun
    • International Journal of Oral Biology
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    • v.43 no.1
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    • pp.43-51
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    • 2018
  • $K^+$ channels are key components of the primary and secondary basolateral $Cl^-$ pump systems, which are important for secretion from the salivary glands. Paroxetine is a selective serotonin reuptake inhibitor (SSRI) for psychiatric disorders that can induce QT prolongation, which may lead to torsades de pointes. We studied the effects of paroxetine on a human $K^+$ channel, human ether-a-go-go-related gene (hERG), expressed in Xenopus oocytes and on action potential in guinea pig ventricular myocytes. The hERG encodes the pore-forming subunits of the rapidly-activating delayed rectifier $K^+$ channel ($I_{Kr}$) in the heart. Mutations in hERG reduce $I_{Kr}$ and cause type 2 long QT syndrome (LQT2), a disorder that predisposes individuals to life-threatening arrhythmias. Paroxetine induced concentration-dependent decreases in the current amplitude at the end of the voltage steps and hERG tail currents. The inhibition was concentration-dependent and time-dependent, but voltage-independent during each voltage pulse. In guinea pig ventricular myocytes held at $36^{\circ}C$, treatment with $0.4{\mu}M$ paroxetine for 5 min decreased the action potential duration at 90% of repolarization ($APD_{90}$) by 4.3%. Our results suggest that paroxetine is a blocker of the hERG channels, providing a molecular mechanism for the arrhythmogenic side effects of clinical administration of paroxetine.

Experimental Study Trends on the Acupuncture Moxibustion Treatment for Visceral Hypersensitivity: Based on the Data of PubMed (내장감각과민의 침구 치료에 대한 실험연구 현황: PubMed를 중심으로)

  • Han, Chang Woo;Choi, Jun-Yong;Park, Seong Ha;Kim, So Yeon
    • Korean Journal of Acupuncture
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    • v.36 no.2
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    • pp.93-103
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    • 2019
  • Objectives : The aim of this study is to review the current trends in experimental studies on the acupuncture moxibustion treatment for visceral hypersensitivity. Methods : PubMed was searched for experimental studies about visceral hypersensitivity and acupuncture/moxibustion. Data were extracted and tabulated from the selected articles about experimental method, intervention, result and mechanism. Results : Total 23 articles were reviewed. Chronic visceral hypersensitivity animal model was applied in 17 studies (74%). Visceral hypersensitivity was measured by abdominal withdrawal reflex scoring or/and abdominal electromyogram. Acupoints like ST25, ST36, ST37, BL25, LI11, BL32 and PC6 were treated by electroacupuncture or moxibustion. All articles reported that electroacupuncture or moxibustion treatment is significantly effective in reducing visceral hypersensitivity. Treatment mechanisms were studied, related to mast cell, serotonin (5-HT) and receptor (5-HT3R and 5-HT4R), substance P (SP), vasoactive intestinal polypeptide (VIP), c-fos positive cell, corticotropin-releasing hormone (CRH), purinergic 2X (P2X)2, P2X3, P2X4, P2X7, N-methyl-D-aspartate (NMDA) receptor (NR1 and NR2B), prokinectin (PK) 1 and PK2. Conclusions : Evidences on acupuncture/moxibustion treatment for visceral hypersensitivity in animal studies warrant more research on effective acupoins, electro-acupuncture methods and treatment durations.

General Pharmacology of G009, a Polysaccharide Isolated from Ganoderma lucidum IY 009

  • Kim, Su-Ung;Lee, Seung-Yong;Lee, Seung-Mok;Jeong, Hoon;Hyun, Ik-Sang;Lee, June-Woo;Han, Man-Deuk;Lee, Eun-Bang;Cheon, Seon-Ah;Kim, Sang-Mee;Kim, Kyung-Ran
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1995.04a
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    • pp.106-106
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    • 1995
  • A polysaccharide, G009, isolated from Ganoderma lucidum IY009 subjected to investigating on general pharmacology. This material at the large oral doses of 1000 and 2000mg/kg in mice did neither exhibit any abnormal behaviors nor effects on central nervous system. It also had no influences on hexobarbital-induced sleeping time, rotarod test and spontaneous activity test at each oral dose of 1000mg/kg in mice. No effects on the body temperature and on acetic acid induced writhing syndrome in mice were observed with its oral administration at 1000mg/kg, and the convulsions induced by strychnine and pentetrazole were not inhibited at its oral doses of 1000mg/kg in mice. The solution of G009 as given intravenously at the doses of 30 and 60mg/kg in rabbit had no influences on blood pressure and respiration rates and depth. In isolated organs of rat uterus and fundus muscles and guinea-pig ileum and trachea, it did not show any contraction or relaxation at the concentration of 2$\times$10$^{-3}$g/ml, and the contractive actions produced by oxytocin, acetylcholine, serotonin and histamine did not inhibited by the same doses. This material showed no effect on intestinal propulsion test in mice and gastric secretion in rats at the oral doses of 1000mg/kg. However, it is interesting that the material exhibited potent inhibition of acidified aspirin induced gastric damage at the doses of 500 and 1000mg/kg in rats.

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General Pharmacology of G009, a Polysaccharide Isolated from Ganoderma lucidum IY 009 (영지의 단백다당체 G009의 일반약리작용)

  • Lee, Eun-Bang;Cheon, Seon-Ah;Kim, Sang-Mee;Kim, Kyung-Ran;Kim, Su-Ung;Lee, Seung-Yong;Lee, seung-Mok;Jeong, Hoon;Hyun, Ik-Sang;Lee, June-Woo;Han, Man-Deuk
    • Biomolecules & Therapeutics
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    • v.2 no.4
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    • pp.369-375
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    • 1994
  • A polysaccharide, G009, isolated from Ganoderma lucidum IY 009, was subjected to investigating on general pharmacology. This material at the large oral doses of 1000 and 2000 mg/kg in mice did not exhibit any abnormal behaviors and another effects on central nervous system. It also had no influences on hexobarbital-induced sleeping time, rotarod test and spontaneous activity test at each oral dose of 1000 mg/kg in mice. No effects on the body temperature and on acetic acid induced writhing syndrome in mice were observed with its oral administration at 1000 mg/kg, and the convulsions induced by strychnine and pentetrazole were not inhibited at its oral doses of 1000 mg/kg in mice. The solution of G009 as given intravenously at the doses of 30 and 60 mg/kg in rabbit had no influences on blood pressure and respiration rates and depth. In isolated organs of rat uterus and fundus muscles and guineapig ileum and trachea, it did not show any contraction or relaxation at the concentrations of 2$\times$10$^{-3}$ g/ml, and the contractive actions produced by oxytocin, acetylcholine, serotonin and histamine were not inhibited at the same doses. This material showed no effect on intestinal propulsion test in mice and gastric secretion in rats at the oral doses of 1000 mg/kg. However, it is interesting that the material exhibited potent inhibition of acidified aspirin induced gastric damage at the doses of 500 and 1000 mg/kg in rats.

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Review of Sexual Dysfunction in Male Schizophrenics (남자 정신분열병 환자에서 성기능장애에 대한 검토)

  • Choi, Yeong Tae;Cheon, Jin Sook;Oh, Byoung Hoon
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.85-98
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    • 2000
  • Objective : There are four possible explanations for the sexual dysfunction of schizophrenics. The first is the possibility of a real structural aspect. The second possibility is that sexual function changes secondary to the illness. The third possibility is that there are medical and sociocultural barriers to sexual expression for chronic schizophrenics. The fourth possibility is that sexual dysfunction due to antipsychotic medication. However, we didn't know the precise cause of sexual dysfunction in schizophrenics. Therefore, the purpose of this study was to explore the mechanism of illness itself and antipsychotics on sexual dysfunction in male schizophrenics. Methods : The serum prolactin(PRL), testosterone(TST), and the plasma serotonin(5-HT) concentrations were measured by radioimmunoassay and high performance liquid chromatography method for 100 healthy male schizophrenics according to the DSM-IV. Concomitantly, the severity of psychotic symptoms using Clinical Global Impression(CGI), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale(PANSS), and the severity of side effects for antipsychotics using Extrapyramidal Side Effects Scale(EPSE), Anticholinergic Side Effects Scale(ACSE), the cognitive function using PANSS-Cognitive Function(PANSS-CF), Mini Mental State Exam-Korean(MMSE-K), and the sexual dysfunction using Sexual Functioning Questionnaire(SFQ), Questionnaire for Sexual Dysfunction in Men were assessed. The PRL, TST, and 5-HT levels of 50 healthy male controls who had no medical, neurological, and psychiatric illnesses were evaluated. The sexual function using SFQ(items FGa, FNa) were also assessed. Furthermore, the correlation with age, education, religion, economic status, age at onset, duration of illnesses, duration of admission, levels of PRL, TST, 5-HT, antipsychotic dosages, potency, benztropine, total duration of medication, EPSE, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K and sexual dysfunctions were identified in male schizophrenics. Results : 1) The frequencies of sexual dysfunctions for schizophrenics(80%) were significantly(p<0.001) higher than those for controls(42%). The sexual dysfunctions according to sexual response cycle were 'low sexual desire' 76%, 'impairment of achieving erection' 75%, 'impairment of maintaining erection' 75%, 'impairment of obtaining orgasm' 32%, 'impairment in the quality of orgasm' 61%, 'impairment in quantity of ejaculate' 44%, 'premature ejaculation' 15%, and 'delayed ejaculation' 50%. 2) The PRL, 5-HT levels of schizophrenics($28.5{\pm}20.6ng/ml$, $298.5{\pm}89.1ng/ml$) were significantly(p<0.001) higher than those of controls($10{\pm}5.6ng/ml$, $169.2{\pm}37.8ng/ml$), while the TST levels of schizophrenics($4.3{\pm}1.5ng/ml$) and controls($4.5{\pm}1.2ng/ml$) were not significantly different. The sexual dysfunctions of schizophrenics who had abnormal 5-HT levels($4.7{\pm}1.3$ scores) were significantly(p<0.05) higher than those of who had normal 5-HT levels($3.8{\pm}1.6$ scores) on item D7. 3) The sexual dysfunctions of unmarried schizophrenics were significantly(p<0.01 : p<0.05) higher than those of married schizophrenics($6.1{\pm}2.8$ scores, $4.7{\pm}1.3$ scores on item FGa : ${\beta}$=-0.211 on item FNa). The sexual dysfunctions were positively correlated with the rise of 5-HT levels(r=0.209, p<0.05 on item D4 and r=0.241, p<0.05 on item D7), the higher age at onset(r=0.275, p<0.01 on item FNa : r=-0.202, p<0.05 on item FDa), the longer duration of illnesses(r=0.237, p<0.05 on item D6), the longer duration of admission(r=0.234, p<0.05 on item D4 : r=0.328, p<0.05 on item D6), the longer total duration of medication(r=0.237, p<0.05 on item D6). However, age, education, religion, economic status, PRL, TST levels, antipsychotics dosage, potency, benztropine, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K scores were not correlated with increased sexual dysfunctions. Conclusions : Male schizophrenics have significantly more sexual dysfunction to compare with controls. The higher frequencies of sexual dysfunctions were low sexual desire and erectile disorder. The unmarried, higher age at onset, and longer duration of diseases were positively correlated with increased sexual dysfunctions. Also high 5-HT levels were positively correlated with increased sexual dysfunctions. This means that studies of plasma 5-HT levels, albeit questionable indicators of central 5-HT function, offer some additional support for the association of sexual dysfunction with excess 5-HT activity as primary pathology of schizophrenia. Our findings suggest that excess 5-HT activity seems to affect the patient's sexual function.

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