OBJECTIVE: Neuroleptic Induced Akathisia(NIA) often occurs in neuroleptic treated patients. Cyproheptadine, an antiserotonergic agent, was used to treat neuroleptic induced akathisia. METHOD: In an open trial 21 neuroleptic-treated patients with akathisia were administrated Cyproheptadine(16mg/day) over 4 days. Assessment of akathisia was evaluated using Barnes' rating scale(BAS) for neuroleptic induced akathisia. The degree of depression and psychosis were assessed by brief psychiatric rating scale(BFRS) and Hamilton rating scale for depression(HAM-D). RESULT: Most patients(20 of 21) with neuroleptic induced akathisia(NIA) showed improvement under the treatment of cyproheptadine. There was no aggravation of psychosis or depression during the treatment. Symptoms of akathisia aggravated when cyproheptadine was discontinued. CONCLUSION: Cyproheptadine may be useful in the treatment of neuroleptic induced akathisia(NIA).
Cyproheptadine* ; Depression ; Humans ; Psychomotor Agitation* ; Psychotic Disorders

This study compared the effectiveness and tolerability of amisulpride and risperidone in patients with psychosis associated with dementia of the Alzheimer's type (DAT). This 8-week open label study randomized 72 patients with DAT associated psychosis either to amisulpride (n=36) and risperidone (n=36). The effectiveness of the treatments was assessed with the Korean version of Neuropsychiatry Inventory (K-NPI) psychosis subscale and total K-NPI and the Clinical Global Impression-Severity of Illness (CGI-S) scale. The Simpson-Angus Rating Scale, the Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale were used for the assessment of side effects. The K-NPI psychosis subscale, total K-NPI and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by the group interaction effect. There were no serious adverse events in both groups. This study showed that either amisulpride or risperidone would be effective and tolerable for treating psychotic symptom associated with DAT. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.
Dementia* ; Dyskinesias ; Humans ; Neuropsychiatry ; Psychomotor Agitation ; Psychotic Disorders* ; Risperidone*

OBJECTIVE: The purpose of the present study was to investigate the efficacy, safety, and tolerability of aripiprazole in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder during acute treatment phase. METHODS: Prospective, multicenter, single group, and 8-week study was conducted in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder. A total of 300 patients were enrolled in the present study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score, and secondary efficacy measures were the PANSS positive and negative subscales scores, and Clinical Global Impression-Severity of Illness (CGI-S) score. Treatment-emergent adverse events, extrapyramidal symptoms (EPS), weight, vital signs, and laboratory tests were assessed as measures of tolerability and safety. RESULTS: Significant improvements in all efficacy measures were achieved by aripiprazole as early as 1-week and sustained through 8-week period. First-episode patients showed greater improvements in PANSS total, positive subscale score, and CGI-S score, compared with recurrent patients. Slightly increased akathisia (+0.32 from baseline score of Barnes Akathisia Rating Scale, p=0.033) and weight gain (1.15+/-3.44 kg, p<0.001) were observed by aripiprazole during 8-week acute treatment phase. CONCLUSION: The present study demonstrated that aripiprazole was effective in acute treatment of positive and negative symptoms of schizophrenia, schizophreniform disorder, and schizoaffective disorder. In general, aripiprazole showed favorable safety and tolerability profiles, although clinicians needed to pay attention to the possibility of akathisia and weight gain by aripiprazole in first-episode patients during acute treatment phase.
Humans ; Piperazines ; Prospective Studies ; Psychomotor Agitation ; Psychotic Disorders ; Quinolones ; Schizophrenia ; Vital Signs ; Weight Gain ; Aripiprazole

OBJECTIVE: The purpose of the present study was to investigate the efficacy, safety, and tolerability of aripiprazole in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder during acute treatment phase. METHODS: Prospective, multicenter, single group, and 8-week study was conducted in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder. A total of 300 patients were enrolled in the present study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score, and secondary efficacy measures were the PANSS positive and negative subscales scores, and Clinical Global Impression-Severity of Illness (CGI-S) score. Treatment-emergent adverse events, extrapyramidal symptoms (EPS), weight, vital signs, and laboratory tests were assessed as measures of tolerability and safety. RESULTS: Significant improvements in all efficacy measures were achieved by aripiprazole as early as 1-week and sustained through 8-week period. First-episode patients showed greater improvements in PANSS total, positive subscale score, and CGI-S score, compared with recurrent patients. Slightly increased akathisia (+0.32 from baseline score of Barnes Akathisia Rating Scale, p=0.033) and weight gain (1.15+/-3.44 kg, p<0.001) were observed by aripiprazole during 8-week acute treatment phase. CONCLUSION: The present study demonstrated that aripiprazole was effective in acute treatment of positive and negative symptoms of schizophrenia, schizophreniform disorder, and schizoaffective disorder. In general, aripiprazole showed favorable safety and tolerability profiles, although clinicians needed to pay attention to the possibility of akathisia and weight gain by aripiprazole in first-episode patients during acute treatment phase.
Humans ; Piperazines ; Prospective Studies ; Psychomotor Agitation ; Psychotic Disorders ; Quinolones ; Schizophrenia ; Vital Signs ; Weight Gain ; Aripiprazole

Restless legs syndrome (RLS) is a common neurological condition characterized by uncomfortable and unpleasant sensations experienced primarily in the legs. Several clinical reports have indicated that many patients with RLS also have the same symptoms in their arms. We report contralateral arm and leg restlessness on resting after acute internal capsular infarction, which resulted in sleep-onset insomnia and disappeared after administering a dopamine receptor agonist. These observations could provide clues to the mechanism underlying the pathophysiology of RLS.
Arm ; Dopamine Agonists ; Humans ; Infarction ; Leg ; Psychomotor Agitation ; Restless Legs Syndrome ; Sensation ; Sleep Initiation and Maintenance Disorders

OBJECTIVE: The aim of this study was to observe the safety and efficacy of ziprasidone in the usual care setting in patients with schizophrenia or acute manic or mixed episodes associated with bipolar disorder. METHODS: A total of 3,391 patients who were treated with ziprasidone were enrolled from 108 centers in Korea. Differences in the clinical global impression of severity and clinical global impression of improvement (CGI-I) were measured after 8+/-1 weeks administration of ziprasidone. Adverse events were observed in all subjects who were administered ziprasidone at least once. In 330 patients, the change of weight was evaluated. RESULTS: Ziprasidone was effective for most of schizophrenia and acute manic or mixed episodes associated with bipolar disorder patients. CGI-I score was improved in 84.8% of PP subjects. Of the subjects who did not complete the study, sixty-four (1.9%) subjects discontinued treatment due to adverse events. The most common adverse events were akathisia, somnolence, extrapyramidal symptoms and insomnia. In total, 6 serious adverse events were reported in 2 subjects, including psychotic disorder and suicidal attempt. Mean 0.9 kg of weight loss was observed. CONCLUSION: Ziprasidone was effective, safe and generally well tolerated for schizophrenia or acute manic or mixed episodes associated with bipolar disorder patients in Korea.
Bipolar Disorder ; Humans ; Korea ; Piperazines ; Psychomotor Agitation ; Psychotic Disorders ; Schizophrenia ; Sleep Initiation and Maintenance Disorders ; Thiazoles ; Weight Loss

The authors studied anxiety, using Zung's self-rating anxiety scale (SAS), in the subjects of 127 male and 38 female patients with anxiety disorder. The authors investigated 165 patients in Yeungnam university hospital from January, 1987 to June, 1991. In order to analyze the data on anxiety scores Pearson's product moment coefficient correlation method and factor analysis were carried out by SPSS/PC+ program. The results were as follows: There was significant difference in the mean averages of total anxiety scores among patients with anxiety disorder and male and female college freshmen: patients with anxiety disorder scored 42.40±7.74, male students scored 32.91±5.70, female students scored 34.48±6.00. The anxiety scores relating to the items of body aches & pains, fatigue, anxiousness, panic and urinary frequency were relatively high in patients with anxiety disorder. The anxiety scores on the items of restlessness, apprehension, dyspnea, sweating, and insomnia were relatively low in patients with anxiety disorder. Twenty-nine anxiety disorder group (17.5%) showed significantly high anxiety scores of 50 or over. The inter-rater reliability of Zung's self-rating anxiety scale was 0.71.
Anxiety Disorders* ; Anxiety* ; Dyspnea ; Fatigue ; Female ; Humans ; Male ; Methods ; Panic ; Psychomotor Agitation ; Sleep Initiation and Maintenance Disorders ; Sweat ; Sweating

OBJECTIVE: Interest in the "at-risk mental state" (ARMS) for psychosis has increased because early intervention is expected to delay or prevent the onset of schizophrenia. However, the optimum intervention strategy remains controversial, especially with regard to antipsychotics. Although administration of antipsychotic medications is often associated with adverse effects and raises ethical considerations, recent studies have shown that some novel antipsychotics are safer and more tolerable for young people than conventional antipsychotics. We investigated whether administration of perospirone, a combined serotonin (5-HT)/dopamine antagonist and 5-HT1A receptor agonist, could alleviate prodromal symptoms and be well tolerated by clinical high risk patients. METHODS: The participants were outpatients seeking help. The Structured Interview for Prodromal Symptoms was performed in patients identified as being at clinical high risk. The Scale of Prodromal Symptoms (SOPS) was also completed and changes of subjective experience were assessed with the Subjective Well-being under Neuroleptics, short version. The incidence of akathisia was recorded by using the Barnes Akathisia Scale. Subjects were monitored for 26 weeks after starting medication. RESULTS: SOPS scores improved significantly after 26 weeks of perospirone therapy, while BAS scores did not show deterioration. No serious adverse events occurred during the study. CONCLUSION: This trial suggests that perospirone therapy provides a clinical benefit for clinical high risk subjects without causing serious adverse events. Although further placebo-controlled studies are needed for confirmation, perospirone might be one of optimum treatments for individuals at imminent risk of psychosis.
Antipsychotic Agents ; Early Intervention (Education) ; Humans ; Incidence ; Outpatients ; Prodromal Symptoms ; Psychomotor Agitation ; Psychotic Disorders ; Receptor, Serotonin, 5-HT1A ; Schizophrenia ; Serotonin

OBJECTIVE: The purpose of this study was to validate the Korean version of the Subjective Well-being under Neuroleptic Treatment Scale-Short Form (KvSWN-K), which has been widely used to assess the quality of life in patients with schizophrenia. METHODS: The subjects for the present study were 140 patients meeting the diagnostic criteria of DSM-IV for schizophrenia. The KvSWN-K with 20 items was administered with the EuroQoL-5D (EQ-5D) to evaluate concurrent validity. Sociodemographic and clinical characteristics were obtained, and the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Social and Occupational Functional Assessment Scale (SOFAS), Simpson-Angus Rating Scale, Barnes Akathisia Scale (BAS), Abnormal Involuntary Movement Scale, and Drug Attitude Inventory were administered to investigate their relationships with the KvSWN-K. RESULTS: The KvSWN-K showed good internal consistency and test-retest reliability. The scores on the subscale and total KvSWN-K showed relevant correlation with scores on the EQ-5D visual analog scale and most subscales of the EQ-5D. Employment status and scores on the SOFAS were significantly positively correlated with the score on the KvSWN-K, and scores on the CDSS, BAS, and subscales and total PANSS scores were significantly negatively correlated with the score on the KvSWN-K. Regression analysis revealed that the CDSS showed the most significant correlations with the KvSWN-K. CONCLUSION: Our findings demonstrated that the KvSWN-K is a reliable and valid assessment tool for evaluating the quality of life in patients with schizophrenia. Depression measured by the CDSS was the most important factor influencing subjective well-being in patients with schizophrenia.
Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Dyskinesias ; Employment ; Humans ; Psychomotor Agitation ; Quality of Life ; Schizophrenia ; Visual Analog Scale

OBJECTIVE: Haloperidol, a typical antipsychotic, has been the preferred agent for the pharmacological treatment of delirium. Recent studies have shown that atypical antipsychotics can be as effective as haloperidol in managing delirium. However, there are few comparative studies between atypical antipsychotics in the treatment of delirium. We investigated the efficacy and side effects of aripiprazole and quetiapine for the treatment of patients with delirium. METHODS: Forty two inpatients with delirium according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Text Revision and Korean version of Delirium Rating Scale-Revised-98 (K-DRS-98) criteria were included. They were assigned to either aripiprazole or quetiapine groups, with a flexible dosing schedule. K-DRS-98 and Clinical Global Impression-Severity (CGI-S) were used for evaluating the severity of delirium. The degree of sedation was assessed by using the Richmond Agitation-Sedation Scale (RASS) six times per day. The severity of side effect was evaluated with the Drug-Induced ExtraPyramidal Symptoms Scale and the Barnes Akathisia Rating Scale. K-DRS-98 and RASS were conducted daily until the remission of delirium while other measurements were conducted twice at the point of baseline and remission. For statistical analysis, t-test, Fisher's exact test, Mann-Whitney test, analysis of covariance were conducted. RESULTS: The scores of K-DRS-98 in both groups significantly decreased after treatment (p<0.001), without any significant differences (F=0.294, p=0.591). There were no significant group differences in the duration of remission (p=0.440) and the degree of improvement in the score of CGI-S. In aripiprazole group, there were significantly more numbers of the stable state defined as daily total scores of RASS > or =-3 (p=0.034). The scores on sleep cycle of K-DRS-98-severity more significantly decreased in the quetiapine group than aripiprazole group (F=4.291, p=0.045). There were no significant side effects both groups including extrapyramidal symptoms. CONCLUSION: These results suggest that both aripiprazole and quetiapine appear to be effective and tolerable in the treatment of delirium. Aripiprazole may be less sedative than quetiapine and it may be more useful than aripiprazole in sleep problem of delirium. To validate our results, further studies with double-blind, placebo-controlled with a large sample will be required.
Antipsychotic Agents ; Appointments and Schedules ; Delirium ; Diagnostic and Statistical Manual of Mental Disorders ; Dibenzothiazepines ; Haloperidol ; Humans ; Inpatients ; Piperazines ; Psychomotor Agitation ; Quinolones