No abstract available.
Depression* ; Depressive Disorder

No abstract available.
Sleep Disorders, Circadian Rhythm*

Amisulpride, a substituted benzamide derivative, is a newer atypical antipsychotics. It mainly blocks presynaptic dopamine D2/D3 autoreceptors which is preferentially located in prefrontal area and blocks postsynaptic dopamine D2/D3 receptors in the limbic system. By these mechanism, amisulpride can improve both negative and positive symptoms. In addition to these action, its property of fast dissociation (Koff) and selectivity to D2/D3 receptors can explain more favorable side effects profiles. A lot of studies showed that amisulpride has equivalent or better efficacy and safety to other atypical antipsychotics. Meta-analysis studies is very informative because it contains many cases of previous studies. So we reviewed some meta-analysis studies which compared amisulpride with placebo or other antipsychotics. On positive symptoms of acute schizophrenia, the most pooled analyses of amisulpride have shown to be equally effective with conventional antispychotics. One meta-analysis study have shown that amisulpride is more effective than conventional drugs. On primary negative symptoms, amisulpride is only agents which is investigated for the efficacy in patients with predominantly negative symptoms. as a results of meta-analysis, amisulpride was shown to be more effective than placebo in primary negative symptoms and have a trend of superiority to conventional agents. The safety and tolerability of amisulpride was equal to or better than other atypical drugs on pooled analysis. The drop out rate was also more favorable than conventional antipsychotics. In Summary, amisulpride showed efficacy similar to that of other atypical antipsychotics in reducing positive symptoms. Moreover, its better properties for negative and affective symptoms, and favorable side effects profiles provides another alternative for treatment of schizophrenia. These results show that amisulpride is a favorable `atypical' antipsychotics, and that 5-HT2/D2 antagonism is not only mechanism of `atypicality'.
Affective Symptoms ; Antipsychotic Agents ; Autoreceptors ; Dopamine ; Humans ; Limbic System ; Meta-Analysis as Topic ; Schizophrenia

OBJECTIVES: The purpose of this study was to investigate the differences between potential neuroanatomical sites of action of(1) a typical antipsychotic drug (haloperidol), (2) an atypical antipsychotic drug (clozapine), and (3) three combinations of both haloperidol and serotonergic agents (haloperidol+buspirone, haloperidol+cyproheptadine, haloperidol+fluoxetine) by comparing their effects on c-fos expression in the rat brain. METHODS: Twenty-four Wistar rats of male sex, weighing 300-450 g, were divided into 6 groups according to the type of the agents tested [vehicle (0.14 M acetic acid 1 ml/kg), haloperidol (1.0 mg/kg), clozapine (20 mg/kg), haloperidol+buspirone (1.0 mg/kg+1.0 mg/kg), haloperidol+cyproheptadine (1.0 mg/kg+1.0 mg/kg), haloperidol+fluoxetine (1.0 mg/kg+0.25 mg/kg)]. The brain of variously treated rat was examined 2 hours after subcutaneousely injection in the neck. The brain was removed immediately after perfusion with 4% paraformaldehyde and placed in a fresh fixative of the same solution. After 12-hr fixation, brain sections (30 mum) of the areas including the medial prefrontal cortex, nucleus accumbens, and lateral striatum were stained by Fos immunohistochemistry, and subjected to light microscopic analytical observations. RESULTS: 1) The number of Fos-positive neurons in the medial prefrontal cortex was significantly increased in the clozapine, haloperidol+buspirone, haloperidol+cyproheptadine, and haloperidol+fluoxetine treated groups than in the control group (p<0.05). But, the haloperidol treated group shows no significant difference. 2) The number of Fos-positive neurons in the nucleus accumbens was significantly increased in the haloperidol clozapine, haloperidol+buspirone, haloperidol+cyproheptadine, haloperidol+fluoxetine treated groups than in the control group (p<0.05). 3) The number of Fos-positive neurons in the lateral striatum was significantly increased in the haloperidol, haloperidol+buspirone, haloperidol+cyproheptadine, haloperidol+fluoxetine treated groups than in the control group (p<0.05). But, the clozapine treated group shows no significant difference. CONCLUSION: These results suggest that differential expression of c-fos in rat brain induced by haloperidol, clozapine, and haloperidol combined serotonergic agents is associated with their clinical and pharmacological differences.
Acetic Acid ; Animals ; Brain* ; Clozapine* ; Haloperidol* ; Humans ; Immunohistochemistry ; Male ; Neck ; Neurons ; Nucleus Accumbens ; Perfusion ; Prefrontal Cortex ; Rats* ; Rats, Wistar ; Serotonin Agents*

Depressive disorders have many faces in clinical features, long-term course, prognosis, and the patients with depressive disorders are not homogeneous group. So, there have been many subtypes of depression suggested and described by clinicians and researchers. But, there is few evidences which support unique pathophysiology and clinical implication about each subtype. The treatment of various subtype of depression is not also specified according to scientific evidence. Nowadays, the rapid development of psychopharmacology and many new antidepressants are making it more possible for clinician to choose antidepressant according to the subtypes of depression and to the characteristics of patients. Therefore, we reviewed the clinical evidence of the treatment for various subtypes of depressive disorders and tried to recommend more efficient antidepressant treatment, although there is a few data for subtypes of depressive disorders. We concluded that the specific choice of antidepressant for each subtypes of depression is not yet possible, because the current subtyping of depression is not clear in many aspects, and the clinical trials have focused mainly in depression in a whole. From now on, more efforts is needed about the more specified subtyping and more specified treatment in order to get more efficacy, safety, and the satisfaction of patients with depressive disorders.
Antidepressive Agents ; Depression ; Depressive Disorder ; Humans ; Prognosis ; Psychopharmacology

5-HT(1A) receptor is implicated in the pathogenesis and the therapeutic mechanism of various psychiatric disorders. Especially, the mechanism of action of selective serotonin reuptake inhibitors (SSRIs) was hypothesized that 5-HT(1A) autoreceptor desensitization plays an important role in the treatment of depression and anxiety. 5-HT(1A) receptor stimulation may also mediate the neurogenesis of prefrontal cortex and hippocampus. The 5-HT(1A) agonism has an important meaning in the treatment of schizophrenia. Most atyptical antipsychotics have the property of 5-HT(2A) antagonist, and some have that of 5-HT(1A) agonist. In the various regions of brain, 5-HT(1A) and 5-HT(2A) have the functionally antagonistic properties. Recently, 5-HT(1A) receptor-related agents have been investigated in the treatment of acute ischemic stroke and Alzheimer's disease. Therefore, the further understanding about the 5-HT(1A) receptors in the brain functions will provide the development of future drugs and the advancement of psychopharmacology.
Alzheimer Disease ; Antipsychotic Agents ; Anxiety ; Autoreceptors ; Brain ; Depression ; Drug Therapy* ; Felodipine ; Hippocampus ; Neurogenesis ; Prefrontal Cortex ; Psychopharmacology ; Receptor, Serotonin, 5-HT1A* ; Schizophrenia ; Serotonin ; Serotonin Uptake Inhibitors ; Stroke

Depressive disorders often develop into chronic course and relapse of symptoms is prevalent. Long-term treatment with antidepressants consolidates the improvement of residual symptoms and prevents relapses and recurrences. In the long-term treatment, the long-term tolerability of antidepressant is a major factor which impact on the compliance and the success of treatment. Although new antidepressants have better side effect profiles than TCA and MAOI, the safety issues of the former are also a concern during continuation and maintenance phases of treatment. Nowadays, weight gain and sexual dysfunction are at a center of concern in this field. SSRI, venlafaxine and mirtazapine can cause weight gain in some patients. Many studies report that weight gain and sexual dysfunction cause significant sufferings and act as major reasons of non-compliance. Bupropion SR is a new antidepressants that has a unique pharmacological property. It produce neither substantial weight gain nor sexual side effect. It was also shown to be effective and well-tolerated in decreasing the risk for relapse of depression. So, Bupropion SR can be used preferentially as a first-line antidepressant or augmentation on other agents in the long-term treatment without significant weight gain and sexual side effects.
Antidepressive Agents* ; Bupropion* ; Compliance ; Depression ; Depressive Disorder ; Humans ; Recurrence ; Weight Gain ; Venlafaxine Hydrochloride

Background: Metformin (MET) has been used to prevent weight gain in patients treated with antipsychotic drugs. However, liraglutide (LIRA), initially used for diabetes, is now considered for obesity treatment. The aim of this study was to investigate the effectiveness and safety of these drugs in patients with psychiatric disorders. Methods: A retrospective chart review was performed on patients prescribed and administered MET and LIRA from January 1, 2017 to August 31, 2023. To assess treatment efficacy, the mean change in the body mass index of the patients before and after drug use was calculated for both medications. Drug safety was evaluated by determining the early discontinuation and occurrence of adverse effects. Results: We collected data from 45 patients, with the majority being women (84.4%). The most frequently diagnosed psychiatric disorders were depressive disorder for LIRA (35.3%) and psychotic disorder for MET (63.6%). No demographic variations were observed between patients who were administered the two types of drugs. The treatment efficacy and safety of both drugs did not show any statistically significant difference. When conducting a subgroup analysis exclusively on patients diagnosed with psychotic disorders (n = 14), MET showed better efficacy; however, no statistically significant difference was observed (−2.48±3.17 vs. 0.56±2.93, t=−1.860, p=0.088). Conclusion LIRA and MET did not show any significant differences in terms of therapeutic efficacy and safety. However, in patients diagnosed with psychotic disorders, MET showed better efficacy and was cost-effective than LIRA. Future studies with larger sample sizes are required to confirm these findings.

Background: Metformin (MET) has been used to prevent weight gain in patients treated with antipsychotic drugs. However, liraglutide (LIRA), initially used for diabetes, is now considered for obesity treatment. The aim of this study was to investigate the effectiveness and safety of these drugs in patients with psychiatric disorders. Methods: A retrospective chart review was performed on patients prescribed and administered MET and LIRA from January 1, 2017 to August 31, 2023. To assess treatment efficacy, the mean change in the body mass index of the patients before and after drug use was calculated for both medications. Drug safety was evaluated by determining the early discontinuation and occurrence of adverse effects. Results: We collected data from 45 patients, with the majority being women (84.4%). The most frequently diagnosed psychiatric disorders were depressive disorder for LIRA (35.3%) and psychotic disorder for MET (63.6%). No demographic variations were observed between patients who were administered the two types of drugs. The treatment efficacy and safety of both drugs did not show any statistically significant difference. When conducting a subgroup analysis exclusively on patients diagnosed with psychotic disorders (n = 14), MET showed better efficacy; however, no statistically significant difference was observed (−2.48±3.17 vs. 0.56±2.93, t=−1.860, p=0.088). Conclusion LIRA and MET did not show any significant differences in terms of therapeutic efficacy and safety. However, in patients diagnosed with psychotic disorders, MET showed better efficacy and was cost-effective than LIRA. Future studies with larger sample sizes are required to confirm these findings.

Background: Metformin (MET) has been used to prevent weight gain in patients treated with antipsychotic drugs. However, liraglutide (LIRA), initially used for diabetes, is now considered for obesity treatment. The aim of this study was to investigate the effectiveness and safety of these drugs in patients with psychiatric disorders. Methods: A retrospective chart review was performed on patients prescribed and administered MET and LIRA from January 1, 2017 to August 31, 2023. To assess treatment efficacy, the mean change in the body mass index of the patients before and after drug use was calculated for both medications. Drug safety was evaluated by determining the early discontinuation and occurrence of adverse effects. Results: We collected data from 45 patients, with the majority being women (84.4%). The most frequently diagnosed psychiatric disorders were depressive disorder for LIRA (35.3%) and psychotic disorder for MET (63.6%). No demographic variations were observed between patients who were administered the two types of drugs. The treatment efficacy and safety of both drugs did not show any statistically significant difference. When conducting a subgroup analysis exclusively on patients diagnosed with psychotic disorders (n = 14), MET showed better efficacy; however, no statistically significant difference was observed (−2.48±3.17 vs. 0.56±2.93, t=−1.860, p=0.088). Conclusion LIRA and MET did not show any significant differences in terms of therapeutic efficacy and safety. However, in patients diagnosed with psychotic disorders, MET showed better efficacy and was cost-effective than LIRA. Future studies with larger sample sizes are required to confirm these findings.