This study was designed to examine the mianserin effects on the negative symptoms of chronic schizophrenia. The chronic schizophrenics(N= 14) diagnosed by DSM-III-R, who were treated at the Catholic University St. Mary Hospital from March 1, 1993 to August 31, 1995, were divided into two groups. One group was composed of 7 patients who were treated with a single classical antipsychotic agent(monotherapy group, MG), and another was composed of 7 Patients treated with combined medications(combined therapy group, CG), including classical antipsychotics plus fixed dose of mianserin 30 mg/day at bed time. Symptoms were evaluated by BPRS(Brief psychiatric Rating Scale) and PANSS(Positive and Negative Syndrome Scale) biweekly for 6 weeks, i.e., total 4 times(at baseline, at 2 weeks, at 4 weeks, and at 6 weeks). The results were as follows: 1) Assessed by PANSS, the negative symptoms of CG were statistically significantly improved more than those of MG at 2 weeks, at 4 weeks, and at 6 weeks. 2) Assessed by PANSS, the positive symptoms of CG were not statistically different from those of MG. In both of CG and MG, there was no difference of the positive symptoms across time intervals. 3) Assessed by PANSS, the total symptoms of CG were statistically significantly improved more than those of MG at 2 weeks, at 4 weeks, and at 6 weeks. But, assessed by BPRS, the total symptoms of CG were not statistically different from those of MG. 4) Assessed by PANSS, the general psychopathology symptoms of CG were not statistically different from those of MG. In CG, the general psychopathology symptoms at 6 weeks were statistically significantly improved more than those of baseline. In summary, mianserin, when combined with classical antipsychotic agent, appears to be effective in diminishing negative symptoms of chronic schizophrenic patients. However, it did not influence positive symptoms.
Antipsychotic Agents ; Humans ; Mianserin* ; Psychopathology ; Schizophrenia*

Depression is one of the most devastating behavioral symptoms in demented patients but there is little evidence about effective and safe pharmacotherapy. We aimed to determine the effectiveness and safety of mirtazapine in treatment of depressed patients with Alzheimer's disease (AD). The consecutive patients with AD who have significant depression were assigned to an 8-week open-label, prospective study. Patients received mirtazapine 15-45 mg/day. The changes in Hamilton Depression Rating Scale (HAM-D) scores were primary outcome measurement. The change in Clinical Global Impression-Severity scale (CGI-S) scores and tolerability-safety profile were the secondary efficacy variables. Thirty-two out of 38 (84.2%) patients completed the study. There was a significant reduction in HAM-D and CGI-S between the pre- and post-treatment with mirtazapine (p<0.01). There was no significant side effect and cognitive deterioration. The results of this open-label pilot study suggest that mirtazapine may be an effective choice for treatment of depressed patients with AD.
Alzheimer Disease ; Behavioral Symptoms ; Dementia ; Depression ; Humans ; Mianserin ; Pilot Projects ; Prospective Studies

Sexual violence crime causes severe trauma to victim's family as well as the victim, and its aftereffect which is hard to be healed can last for the entire lifetime. And thus plenty of social cost is incurred due to the crime. It has long been reported that paraphilia is associated with sexual offenders and sexual violence. In this study, the previous foreign data on the psychiatric medication used for sexual offender or paraphilia were summarized for the first time in Korea, and the possibility of medication in Korea was examined. As for the drugs used for sexual offender or paraphilia, SSRI was most frequently reported and besides that, tricyclic antidepressant, antipsychotics, antiepileptic drugs, mirtazapine, and naltrexone were reported.
Anticonvulsants ; Antipsychotic Agents ; Crime ; Criminals ; Humans ; Korea ; Mianserin ; Naltrexone ; Paraphilic Disorders ; Sex Offenses

The aim of the present study was to retrospectively identify sexual dysfunction changes in the patients under mirtazapine-augmented serotonin reuptake inhibito (SSRI) treatment. The study comprised medical records of 20 outpatients, under mirtazapine-augmented SSRI treatment for their major depressive disorder, who had been selected among the patients that had developed sexual dysfunction to previous treatment as monotherapy, with SSRI for at least six weeks. These drugs were maintained and mirtazapine were added (15-45 mg/day). There was a significant difference in scores between baseline and week 4 or week 8 on the both Hamilton Depression Rating and Arizona Sexual Experience Scale. According to Clinical Global Impression-Improvement, 68.4% of the patients were responders. The use of low-dose mirtazapine as an add-on treatment to SSRIs appears to be an effective and well-tolerated augmenttaion for sexual dysfunction caused by SSRIs.
Arizona ; Depression ; Depressive Disorder, Major ; Humans ; Medical Records ; Mianserin ; Outpatients ; Retrospective Studies ; Serotonin

OBJECTIVE: There was a recent study to explore the cerebral regions associated with sexual arousal in depressed women using functional magnetic resonance imaging (fMRI). The purpose of this neuroimaging study was to investigate the effects of antidepressant treatment on sexual arousal in depressed women. METHODS: Seven depressed women with sexual arousal dysfunction (mean age: 41.7+/-13.8, mean scores of the Beck Depression Inventory (BDI) and the 17-item Hamilton Rating Scale for Depression (HAMD-17): 35.6+/-7.1 and 34.9+/-3.1, respectively) and nine healthy women (mean age: 40.3+/-11.6) underwent fMRI before and after antidepressant treatment. The fMRI paradigm contrasted a 1 minute rest period viewing non-erotic film with 4 minutes of sexual stimulation viewing an erotic video film. Data were analyzed by SPM 2. The relative number of pixels activated in each period was used as an index of activation. All depressed women were treated with mirtazapine (mean dosage: 37.5 mg/day) for 8 to 10 weeks. RESULTS: Levels of brain activity during sexual arousal in depressed women significantly increased with antidepressant treatment (p<0.05) in the regions of the hypothalamus (3.0% to 11.2%), septal area (8.6% to 27.8%) and parahippocampal gyrus (5.8% to 14.6%). Self-reported sexual arousal during visual sexual stimulation also significantly increased post-treatment, and severity of depressive symptoms improved, as measured by the BDI and HAMD-17 (p<0.05). CONCLUSION: These results show that sexual arousal dysfunction of depressed women may improve after treatment of depression, and that this improvement is associated with increased activation of the hypothalamus, septal area, and parahippocampal gyrus during sexual arousal.
Arousal ; Brain ; Depression ; Female ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Mianserin ; Neuroimaging ; Parahippocampal Gyrus ; Septum of Brain

OBJECTIVES: Patient's behavior features are important factors which influences the clinical judgement including diagnosis. However, most psychiatrists build up a picture of patients' behavior from an amalgamation of their own brief observations and nurses' reports, which often lack in the objectiveness. Several behavioral scales have been developed to alleviate this difficulty, but the poor efficiency and reliability of these scales have made them less useful. The recently developed Ward Daily Behavior Scale is an objective tool for evaluating all the daily noteworthy behaviors of patients, and is easily applicable to wide ranges of diagnoses and ages. This study tried to prove the reliability and validity of the Ward Daily Behavior Scale-Korean version. METHODS: The 112 patients, 63 males and 49 females, at a chronic psychiatric inpatient ward were selected as subjects. Experienced and unexperienced nurses rated patients' behaviors independently with the Ward Daily Behavior Scale-Korean version, after observing behaviors of subjects for 8 hours during day duty time. And then we tested the inter-rater reliability, internal consistency, and concurrent validity of this scale. RESULTS: The Ward Daily Behavior Scale-Korean version proved to be both reliable and valid for measuring of behaviors of psychiatric inpatients. CONCLUSIONS: The Ward Daily Behavior Scale-Korean version will be a valuable tool to observe and quantify patients' behavior in psychiatric wards.
Diagnosis ; Female ; Humans ; Inpatients ; Male ; Mianserin* ; Psychiatry ; Reproducibility of Results ; Schizophrenia* ; Weights and Measures

OBJECTIVE: Some patients with schizophrenia may need mirtazapine augmentation to improve negative and cognitive symptoms. However there have been a few studies about the tolerability of mirtazapine augmentation to antipsychotics such as akathisia, extrapyramydal symptoms, weight gain, and body mass index (BMI). METHODS: This study was an eight-week double-blind, randomized controlled trial (RCT) of mirtazapine augmentation to risperidone. Twenty-one stabilized participants diagnosed with schizophrenia and undergoing treatment with risperidone were randomized to adjunctive treatment with mirtazapine (15 mg/day for the first two weeks, 30 mg/day for the next six weeks) or placebo. Eleven patients were assigned to the mirtazapine group, and nine patients were given placebo. RESULTS: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS). However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05). CONCLUSION: These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine. Our results should be replicated in a large-scale lengthy trial.
Antipsychotic Agents ; Body Mass Index ; Humans ; Mianserin ; Neurobehavioral Manifestations ; Psychomotor Agitation ; Risperidone ; Schizophrenia ; Weight Gain

OBJECTIVES: Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. METHODS: The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. RESULTS: Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92 (28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). CONCLUSIONS: In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.
Antidepressive Agents ; Anxiety ; Citalopram ; Depression ; Hospitals, General ; Humans ; Inpatients ; Korea ; Mianserin ; Paroxetine ; Psychiatry ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

It was aimed to investigate the effect of 5-HT2C receptor modulation on the rat behavioral responses induced by 1-(m-chlorophenyl) piperazine(mCPP), a major metabolite of trazodone. The animal activities(ambulation, stereotypy and total activity) were measured for 3 hours following mCPP administration, using an animal activity meter which accumulates the frequency of light beam interruption. mCPP(1-10 mg / kg, i.p.) induced dose-dependent decreases in ambulation and stereotypy, consequently leading to hypoactivity. The hypoactivity induced by mCPP(1mg / kg, i.p.) was significantly inhibited by pretreatment with mianserin(1mg / kg, i.p.), an antagonist with high affinity for 5-HT2C receptor, whereas pretreatment with 5-HT2 antagonists, ketanserin and ritanserin(1mg / kg, i.p., respectively) was without effect. Furthermore, long-term pretreatment with imipramine(10mg / kg, i.p., b.i.d. for 2 weeks) markedly attenuated the mCPP-induced hypoactivity. Mianserin and imipramine in the absence of mCPP did not increase the animal activity. Taken together, these results indicate that the mCPP-induced hypoactivity is mediated by 5-HT2C receptor, and that selective 5-HT2C antagonists and down regulation of 5-HT2C receptor might be useful for inhibiting the mCPP-induced hypoactivity.
Animals ; Down-Regulation ; Imipramine ; Ketanserin ; Mianserin ; Rats ; Receptor, Serotonin, 5-HT2C* ; Serotonin 5-HT2 Receptor Antagonists ; Trazodone ; Walking

OBJECTIVE: The objective of this study was to identify patterns of brain activation elicited by erotic visual stimuli in patients treated with either Selective Serotonin Reuptake Inhibitors (SSRIs) or mirtazipine. METHODS: Nine middle-aged men with major depressive disorder treated with an SSRI and ten middle-aged men with major depressive disorder treated with mirtazapine completed the trial. Ten subjects with no psychiatric illness were included as a control group. We conducted functional brain magnetic resonance imaging (fMRI) while a film alternatively played erotic and non-erotic contents for 14 minutes and 9 seconds. RESULTS: The control group showed activation in the occipitotemporal area, anterior cingulate gyrus, insula, orbitofrontal cortex, and caudate nucleus. For subjects treated with SSRIs, the intensity of activity in these regions was much lower compared to the control group. Intensity of activation in the group treated with mirtazapine was less than the control group but grea-ter than those treated with SSRIs. Using subtraction analysis, the SSRI group showed significantly lower activation than the mirtazapine group in the anterior cingulate gyrus and the caudate nucleus. CONCLUSION: Our study suggests that the different rates of sexual side effects between the patients in the SSRI-treated group and the mirtazapine-treated group may be due to different effects on brain activation.
Brain ; Caudate Nucleus ; Depressive Disorder, Major ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Male ; Mianserin ; Serotonin Uptake Inhibitors