Since the introduction in 1996 of the novel antipsychotic risperidone in Korea, clinical experiences with this agent for the treatment of schizophrenia have been accumulated. This article attempts to review the published literature on clinical effects of risperidone in Korean patients with schizophrenic disorder. All available clinical articles by Korean authors or involving Korean patients were searched through electronic databases (KISEP and KMBASE) or manually. Retrieved articles were primarily written in Korean and were of several types (original article, case report, review and tutorial), and addressed various issues:efficacy, safety and tolerance, quality of life and subjective well-being, pharmacoeconomics, optimal dose and titration rate, etc. The main results are as follows. Many clinical trials to date have shown that risperidone is an effective antipsychotic agent in the treatment of positive and negative symptoms, with a milder side effect profile, in particular much less EPS than haloperidol. The effects were favorable even in chronic or treatment-resistent patients. It appears to have additional effects on quality of life and subjective well-being. Preliminary evidence suggested that risperidone may improve some types of cognitive function. Weight gain was a major problem although the weight increase was less severe than that seen with clozapine and olanzapine. Some experimental studies demonstrated prolactin elevation in patients treated with risperidone;however, clinical significance of hyperprolactinemia was unclear. Various specific cases of adverse events were reported during risperidone therapy, including new onset of manic symptoms, neuroleptic malignant syndrome, stuttering, premature ventricular contraction and hepatotoxicity;however, the numbers of cases were very few, the causal relationship was not clear in some cases, and there were no fatalities or life threatening events. At present the medication costs for risperidone are much greater than those for conventional drugs. However, risperidone therapy may be associated with substantial cost benefits, when total health service costs and quality of life were taken together into account. The target dose found to be effective was lower than the originally proposed target dose of 6 mg/day. A slower titration was also found to be preferable. Taken together, in spite of lacking in randomized controlled clinical trials and long term studies, Korean literature on risperidone use for schizophrenia provides valuable information to clinicans regarding the effective use of risperidone. Risperidone should be a first line drug for the treatment of Korean patients with schizophrenic disorder.
Clozapine ; Cost-Benefit Analysis ; Economics, Pharmaceutical ; Haloperidol ; Health Services ; Humans ; Hyperprolactinemia ; Korea ; Neuroleptic Malignant Syndrome ; Prolactin ; Quality of Life ; Risperidone* ; Schizophrenia* ; Stuttering ; Ventricular Premature Complexes ; Weight Gain

OBJECTIVE: Level of education has been reported to modify the associations between vascular risk factors and cognitive impairment. This study aimed to test this hypothesis in a community dwelling Korean elders with relative cognitive impairment. METHOD: The study group consisted of 341 participants with the Korean version of Mini-Mental State Examination (MMSE-K) scores of 24 or below. The cognitive impairment was categorized into mild (MMSE-K 21-24) or moderate to severe (MMSE-K <21). For each participant, diagnoses for vascular risk factors were ascertained, and resting blood pressure and non-fasting blood glucose and serum cholesterol levels were examined. RESULTS: In the total sample, after adjustment for age, past occupation, physical activities of daily living and cholesterol levels, the worse cognitive function (MMSE-K <21) was associated with raised systolic blood pressure and the diagnosis of diabetes. However, the stratified analyses according to education level revealed that these associations were only significant in those with no formal education. In addition, the higher level of non-fasting blood glucose was significantly associated with the worse cognitive function only for those with no formal education CONCLUSION: Older Koreans with low levels of education may be particularly vulnerable to cognitive impairment associated with risk factors for cerebrovascular disease. This has an important implication for public health strategies regarding the prevention of dementia.
Blood Glucose ; Blood Pressure ; Cholesterol ; Dementia ; Diagnosis ; Education* ; Motor Activity ; Occupations ; Public Health ; Risk Factors*

BACKGROUND AND PURPOSE: The positive effects of galantamine on cognition and activities of daily living (ADL) in Alzheimer's disease (AD) are thought to be mediated via improvements in attention. The purpose of this study was to determine the effect of galantamine on attention in AD patients using a computerized attention test and to elucidate the relationship between improvements in attention and change in cognition and ADL. METHODS: In this multicenter, open-label, prospective study, patients with mild to moderate AD received galantamine and then submitted to computerized attention tests, the Alzheimer's Disease Assessment Scale-cognitive subscale, and instrumental ADL (IADL) at baseline, 4 weeks, and 12 weeks. The differences in reaction time on computerized tests were explored relative to the changes in cognition and IADL. RESULTS: After 12 weeks of taking the trial medication there was a significant reduction from baseline levels in the choice reaction time (baseline, 5,216+/-3,650 sec; 12 weeks, 4,139+/-2,920 sec; p<0.01) and the simple reaction time (baseline, 1,089+/-782 sec; 12 weeks, 908+/-606 sec; p<0.01). Correlation analyses of changes in choice or simple reaction times relative to cognition and ADL measures yielded no significant associations. The improvement in attention observed at 4 weeks of galantamine treatment was not associated with any significant changes in outcome measures at the end of trial. CONCLUSIONS: This study found no significant association between the improvement in attention after treatment with galantamine and changes in cognition and ADL in patients with mild to moderate AD, despite the significant improvement in attention over the course of the treatment.
Activities of Daily Living* ; Alzheimer Disease* ; Cognition* ; Galantamine* ; Humans ; Outcome Assessment (Health Care) ; Prospective Studies ; Reaction Time

OBJECTIVES: An important therapeutic target for patients with acute coronary syndrome (ACS) is improved quality of life (QoL). This study investigated clinical factors affecting QoL in patients with ACS. METHODS: We evaluated 82 patients two weeks, and again at three months, after their ACS onset (diagnosis?), using the World Health Organization Quality of Life Instrument-Brief Form to assess QoL. For estimating their severity of depression, we used the Hamilton Depression Rating Scale. We used their Global Registry of Acute Coronary Events risk scores to measure the patients' ACS. Sociodemographic characteristics included age, gender, education, marital status, religion, current occupation, and monthly income. RESULTS: Depressive symptoms at baseline predicted higher QoL at both follow-ups. Some other factors, such as education, religion, and current occupation, were also significantly associated with QoL at three months' follow-up. CONCLUSION: Depression was the most important factor affecting QoL in patients with ACS, at both two weeks' and three months' follow-up.
Acute Coronary Syndrome ; Depression ; Follow-Up Studies ; Humans ; Marital Status ; Occupations ; Quality of Life ; World Health Organization

Simvastatin is a lipid-lowering drug that is metabolized to its active metabolite simvastatin acid (SA). We developed and validated a sensitive liquid chromatography-tandem mass spectrometry (LC/MS/MS) method to quantitate SA in human plasma using a liquid-liquid extraction method with methanol. The protonated analytes generated in negative ion mode were monitored by multiple reaction monitoring. Using 500-mL plasma aliquots, SA was quantified in the range of 0.1-100 ng/mL. Calibration was performed by internal standardization with lovastatin acid, and regression curves were generated using a weighting factor of 1/χ2. The linearity, precision, and accuracy of this assay for each compound were validated using quality control samples consisting of mixtures of SA (0.1, 0.5, 5, and 50 ng/mL) and plasma. The intra-batch accuracy was 95.3-107.8%, precision was -2.2% to -3.7%, and linearity (r2) was over 0.998 in the standard calibration range. The chromatographic running time was 3.0 min. This method sensitively and reliably measured SA concentrations in human plasma and was successfully used in clinical pharmacokinetic studies of simvastatin in healthy Korean adult male volunteers.
Adult ; Calibration ; Humans* ; Liquid-Liquid Extraction ; Lovastatin ; Male ; Mass Spectrometry* ; Methanol ; Plasma* ; Protons ; Quality Control ; Running ; Simvastatin* ; Volunteers