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Korean Journal of Psychopharmacology

1990  to  Present  ISSN: 1017-5717

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A Case of Mefloquine-Induced Psychosis.

Myung Jin JO ; Jai Sung NOH

Korean Journal of Psychopharmacology.2013;24(1):35-37.

Mefloquine is a common anti-malarial agent used for the treatment and prophylaxis of malaria. Here we report a case of a 39-year-old, otherwise healthy woman from South Korea, who had developed visual and auditory hallucination with sleep disturbance after oral administration of mefloquine before traveling to an endemic region. To our knowledge, this would be the first reported case of mefloquine-induced psychosis in South Korea to date. This report underlines the importance of awareness and detection of neuropsychiatric side effects of mefloquine.
Administration, Oral ; Female ; Hallucinations ; Humans ; Malaria ; Mefloquine ; Psychotic Disorders ; Republic of Korea

Administration, Oral ; Female ; Hallucinations ; Humans ; Malaria ; Mefloquine ; Psychotic Disorders ; Republic of Korea

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Korean Medication Algorithm for Depressive Disorder (IV): Child and Adolescent/The Elderly/Female.

Hee Ryung WANG ; Won Myong BAHK ; Young Min PARK ; Hwang Bin LEE ; Hoo Rim SONG ; Jong Hyun JEONG ; Jeong Seok SEO ; Eun Sung LIM ; Jeong Wan HONG ; Won KIM ; Duk In JON ; Jin Pyo HONG ; Kyung Joon MIN

Korean Journal of Psychopharmacology.2013;24(1):25-34.

OBJECTIVE: Since the introduction of selective serotonin reuptake inhibitor in 1980s, there have been many changes in the treatment strategies for depressive disorders. To be of help for clinicians to select appropriate treatment strategies, Korean Medication Algorithm Project for Major Depressive Disorder was developed in 2002 and revised in 2006. To reflect changes in treatment pattern for depressive disorders since 2006, we revised the previous algorithm and developed Korean Medication Algorithm Project for Depressive Disorder 2012 (KMAP-DD 2012). METHODS: 123 psychiatrists who have vast clinical experiences in treating depressive disorders are primarily selected, and the survey was sent to them via mails. Among them, 67 psychiatrists answered the survey. This survey was composed of 44 questionnaires of which the contents covered from overall treatment strategies to treatment strategies under the specific circumstances. Based on 95% confidence interval and overall scores, each treatment of option was classified into three categories of recommendation; first-line, second-line, and third-line treatment option. RESULTS: In child and adolescent, antidepressant monotherapy was selected as first-line treatment option for mild, moderate, and severe episode without psychotic features. The combination of antidepressant and atypical antipsychotics was advocated as first-line treatment option for severe episode with psychotic features. In geriatric depression, antidepressant monotherapy was advocated as treatment of choice for mild to moderate episode. For severe episode without psychotic features, antidepressant monotherapy was selected as first-line treatment option. For severe episode with psychotic features, combination of antidepressant and atypical antipsychotics was selected as treatment of choice. In premenstrual dysphoric disorder, antidepressant monotherapy was advocated as first-line treatment option. In postpartum depression, antidepressant monotherapy was selected as first-line treatment option for mild to moderate episode. For severe episode without psychotic features, both antidepressant monotherapy and combination of antidepressant and atypical antipsychotics were selected as first-line treatment option. For severe episode with psychotic features, both combination of antidepressant and atypical antipsychotics and combination of mood stabilizer and atypical antipsychotics were advocated as first-line treatment option. CONCLUSION: In KMAP-DD 2012, the recommendations for treatment options in Child and Adolescent Depressive Disorder and Geriatric Depression were newly introduced. In aspects of treatment options for Female Depression, KMAP-DD 2006 and KMAP-DD 2012 had some similarities. But there were some changes of the treatment strategies in KMAP-DD 2012 which seemed to reflect recent study results.
Adolescent ; Aged ; Antipsychotic Agents ; Child ; Depression ; Depression, Postpartum ; Depressive Disorder ; Depressive Disorder, Major ; Female ; Humans ; Postal Service ; Psychiatry ; Surveys and Questionnaires ; Serotonin

Adolescent ; Aged ; Antipsychotic Agents ; Child ; Depression ; Depression, Postpartum ; Depressive Disorder ; Depressive Disorder, Major ; Female ; Humans ; Postal Service ; Psychiatry ; Surveys and Questionnaires ; Serotonin

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Korean Medication Algorithm for Depressive Disorder 2012 (III): The Subtypes of Depression.

Young Min PARK ; Won KIM ; Eun Sung LIM ; Hwang Bin LEE ; Jong Hyun JEONG ; Hoo Rim SONG ; Jeong Seok SEO ; Jeong Wan HONG ; Hee Ryung WANG ; Won Myong BAHK ; Duk In JON ; Jin Pyo HONG ; Kyung Joon MIN

Korean Journal of Psychopharmacology.2013;24(1):18-24.

OBJECTIVE: Recently, the pharmacotherapy including antidepressants in treating depression is widely used. However, as a result of newer agents that are continuously introduced, pharmacological treatment strategy is also changing. To catch up this trend, Korean Medication Algorithm Project for Depressive Disorder was developed in 2002 and revised in 2006. Since the last revision, the third revision reflected the new research result and the latest trends in the areas of pharmacological treatment. METHODS: One hundred and twenty three psychiatrists who have vast clinical experiences in depressive disorder are primarily selected then survey was sent to them via mail, 67 surveys were retried. This survey is constructed with 44 questionnaires in which contained from overall treatment strategies to treatment strategies under the specific circumstances. Each treatment strategy or treatment option is evaluated with the overall score of nine and the following 95% confidence interval result treatment option were divided into three phases of recommendation; primary, secondary, tertiary. RESULTS: For dysthymic disorder, antidepressant monotherapy including selective serotonin reuptake inhibitor (SSRI) [(es)citalopram, fluoxetine, sertraline, paroxetine], serotonin-norepinephrine reuptake inhibitor (SNRI) (venlafaxine, duloxetine, milacipran), and mirtazapine, was recommended as the first line medications. For melancholic type, SSRI, SNRI, and mirtazapine were recommended as the first line medications. For atypical type and seasonal pattern, bupropion as well as SSRI, SNRI, and mirtazapine, were recommended as the first line medications. CONCLUSION: The preferences of antidepressants in experts were different according to the subtype of depression. These results suggest that clinicians have to consider the subtype of depression in the treatment of depressive disorders.
Antidepressive Agents ; Bupropion ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Dysthymic Disorder ; Fluoxetine ; Mianserin ; Postal Service ; Psychiatry ; Surveys and Questionnaires ; Seasons ; Serotonin ; Sertraline ; Thiophenes ; Duloxetine Hydrochloride

Antidepressive Agents ; Bupropion ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Dysthymic Disorder ; Fluoxetine ; Mianserin ; Postal Service ; Psychiatry ; Surveys and Questionnaires ; Seasons ; Serotonin ; Sertraline ; Thiophenes ; Duloxetine Hydrochloride

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Use of Atypical Antipsychotics in Attention-Deficit Hyperactivity Disorder.

Min A SONG ; Hyun Ju HONG

Korean Journal of Psychopharmacology.2013;24(1):11-17.

Psychopharmacotherapy is one of the effective treatments for the children and adolescents with attention-deficit hyperactivity disorder (ADHD). If there were a marginal improvement or significant adverse effects after having the first line medication such as psychostimulants and atomoxetine, the youth with ADHD can take alternative medications. If they have comorbidities such as disruptive behavior disorder, bipolar disorder, mental retardation and tic disorder, they need to have more medications. Recently, prescriptions of atypical antipsychotics were increasing among them. The efficacy, safety, and tolerability of atypical antipsychotics in the youth should be considered.
Adolescent ; Antipsychotic Agents ; Attention Deficit and Disruptive Behavior Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Humans ; Intellectual Disability ; Prescriptions ; Propylamines ; Tic Disorders ; Atomoxetine Hydrochloride

Adolescent ; Antipsychotic Agents ; Attention Deficit and Disruptive Behavior Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Humans ; Intellectual Disability ; Prescriptions ; Propylamines ; Tic Disorders ; Atomoxetine Hydrochloride

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Depression as an Inflammatory Disease.

Hoo Rim SONG ; Young Sup WOO ; Won Myong BAHK

Korean Journal of Psychopharmacology.2013;24(1):5-10.

Inflammation is an immune response engaged with the reciprocal interactions among the neural, endocrine and immune system. From this psychoneuroimmunological view, inflammation is one of important allostatic loads contributory to depression. Sickness behaviors in the inflammatory state share many parts of depressive symptoms and patients treated with cytokines for various illnesses are at increased risk of developing depression. The dysfunctions of cytokines and hypothalamic-pituitary-adrenal axis have been widely investigated to find out inflammatory responses. Inflammatory mediators such as cytokines, glucocorticoid and C-reactive protein affect the etiopathogenesis of depression via altered monoamine and glutamate neurotransmission, glucocorticoid receptor resistance and neurogenesis. Although inflammation is subtle and not easy to be detected in the wide population, it is basal pathophysiology and plays an important role at least to the vulnerable patients. From this perspectives, inflammatory markers may be useful in the diagnosis and prediction of treatment response, leading to the possibility of tailored treatments. Understanding depression as a kind of inflammatory disease would provide new opportunities for the psychiatry beyond monoamine theory.
Allostasis ; Axis, Cervical Vertebra ; C-Reactive Protein ; Cytokines ; Depression ; Glutamic Acid ; Humans ; Illness Behavior ; Immune System ; Inflammation ; Neurogenesis ; Psychoneuroimmunology ; Receptors, Glucocorticoid ; Synaptic Transmission

Allostasis ; Axis, Cervical Vertebra ; C-Reactive Protein ; Cytokines ; Depression ; Glutamic Acid ; Humans ; Illness Behavior ; Immune System ; Inflammation ; Neurogenesis ; Psychoneuroimmunology ; Receptors, Glucocorticoid ; Synaptic Transmission

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A Case of Agranulocytosis Induced by Risperidone and Treated with Granulocyte-Colony Stimulating Factor.

Won KIM ; Jong Jin KIM ; Young Sup WOO ; Tae Youn JUN ; Won Myong BAHK

Korean Journal of Psychopharmacology.2005;16(6):529-533.

Agranulocytosis is a severe hematologic complications of clozapine, but risperidone was not shown to induce agranulocytois. Nevertheless, some cases of risperidone-induced agranulocytosis were being reported, but there was no report yet in Korea. Recently we experienced that a female patient taking risperidone suffered by fever and agranulocytosis, so treated by discontinuation of risperidone and granulocyte-colony stimulating factor (G-CSF). A 54 year-old depressed and psychotic women started a treatment with risperidone. On hospital day 11, agranulocytosis accompanied with fever developed. Risperidone was discontinued and G-CSF was administered. On hospital day 13, the hematologic complication was improved. Thereafter olanzapine was administerd for treatment of psychotic symptoms. On hospital day 41, the patient discharged with normal hematologic profile and improved state of depressive and psychotic symptoms. Agranulocytosis induced by risperidone is not frequent, but it can develop in some vulnerable patients. So, if a patient taking risperidone shows fever, chill, sore throat, hematologic examination should be carried out. Once agranulocytosis develops, immediate discontinuation of risperidone and other potential drug. Thereafter, preventive antibiotics and shortening in duration of aganulocytosis are needed.
Agranulocytosis* ; Anti-Bacterial Agents ; Clozapine ; Female ; Fever ; Granulocyte Colony-Stimulating Factor ; Humans ; Korea ; Middle Aged ; Pharyngitis ; Risperidone*

Agranulocytosis* ; Anti-Bacterial Agents ; Clozapine ; Female ; Fever ; Granulocyte Colony-Stimulating Factor ; Humans ; Korea ; Middle Aged ; Pharyngitis ; Risperidone*

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Association Study of Functional micro Opioid Receptor Genotypes with Korean Female Alcoholics.

Cheol Joong KANG ; Sung Gon KIM ; Won Tan BYUN ; Yun Jin KIM ; In Bok HWANG ; Seong Yeon KIM

Korean Journal of Psychopharmacology.2005;16(6):521-528.

OBJECTIVES: Previous studies have shown that the endogenous opioid system, which plays an important role in drinking behavior, might be related to the genetic etiology of alcohol dependence. And a recent study reported that the affinity of micro opioid receptor, which is closely related to the endogenous opioid system activity, is affected by the genotype of micro opioid receptor gene (OPRM1) A118G. To investigate the gender difference in genetic etiology of alcohol dependence, this study examined the association of the genotype of OPRM1 A118G with female alcohol dependence in Koreans. METHODS: The author studied the genotype of OPRM1 A118G in 106 male and 35 female Korean with alcohol dependence and 80 male and 60 female healthy Koreans as control. RESULTS: 1) A statistically significant increase in A/G or G/G (G+) genotype of OPRM1 A118G was observed in women with alcohol dependence compared to the controls. 2) Among men with alcohol dependence, no significant difference in OPRM1 A118G polymorphism was observed relative to the age at which drinking started, age of onset of alcohol-related problems, age of first admission to psychiatric hospital for alcohol-related problems, drinking days per month, drinks per drinking day, family history of alcohol dependence in the first-degree relatives or history of severe alcohol withdrawal symptoms. But the drinking days per month is significantly less in those who have A/G or G/G genotypes of OPRM1 A118G. CONCLUSION: These results suggest that G+ genotypes of micro opioid receptor gene A118G are important genetic factors in the etiology of female alcohol dependence.
Age of Onset ; Alcoholics* ; Alcoholism ; Drinking ; Drinking Behavior ; Female* ; Genotype* ; Hospitals, Psychiatric ; Humans ; Male ; Receptors, Opioid* ; Substance Withdrawal Syndrome

Age of Onset ; Alcoholics* ; Alcoholism ; Drinking ; Drinking Behavior ; Female* ; Genotype* ; Hospitals, Psychiatric ; Humans ; Male ; Receptors, Opioid* ; Substance Withdrawal Syndrome

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Association between Obsessive-Compulsive Disorder and Dopamine Receptor D4 Gene.

Se Joo KIM ; Sang Woo YOO ; Yoon Young NAM ; Hong Shick LEE ; Chan Hyung KIM

Korean Journal of Psychopharmacology.2005;16(6):513-520.

OBJECTIVE: The definite causes of obsessive-compulsive disorder (OCD) are still unknown. Evidences from familial, twin and segregation studies support the role of a genetic component in the etiology of OCD. There are growing evidences that OCD has specific neurochemical and neuroanatomical basis. It has been shown that serotonergic neurons play the predominant pathophysiological role in OCD. Recently, it has also been proposed that neurotransmitters other than serotonin play a role in the pathophysiology of OCD, and a series of studies have provided evidence that dopamine is involved in some OCD patients. Therefore, the aims of this study were to investigate the association between dopamine receptor D4 (DRD4) and OCD. METHODS: One hundred and fifteen OCD patients and 160 normal controls participated in this study. Genomic DNA was extracted from their blood. The genotypes and allele frequencies of the DRD4 polymorphism between OCD group and control group were compared. OCD patients were classified into early onset group (age of onset <17) and late onset group (age of onset > or =17) according to their onset age and the genotype and allele frequency were compared between two groups. Using principal component analysis, we had already derived 4 factors from 13 main contents of YBOCS checklist in the previous study and in this study, we investigated the association between these three factors and DRD4 genotypes. RESULTS: In this case-control study, we could find that the L-genotype frequencies of DRD4 were significantly higher in OCD than in normal control groups (chi2 test, p=0.04). There were no difference in genotype frequencies between early onset OCD group and late onset OCD group. In OCD group, patients with L-genotype had higher scores for the religious/somatic factor than the other groups (t test, p=0.009). CONCLUSIONS: The L-genotype of DRD4 may have negative effects on the development of OCD and religious/somatic factor of the obsessive-compulsive symptoms.
Age of Onset ; Case-Control Studies ; Checklist ; DNA ; Dopamine Plasma Membrane Transport Proteins ; Dopamine* ; Gene Frequency ; Genotype ; Humans ; Neurotransmitter Agents ; Obsessive-Compulsive Disorder* ; Principal Component Analysis ; Receptors, Dopamine* ; Serotonergic Neurons ; Serotonin

Age of Onset ; Case-Control Studies ; Checklist ; DNA ; Dopamine Plasma Membrane Transport Proteins ; Dopamine* ; Gene Frequency ; Genotype ; Humans ; Neurotransmitter Agents ; Obsessive-Compulsive Disorder* ; Principal Component Analysis ; Receptors, Dopamine* ; Serotonergic Neurons ; Serotonin

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Changes of Cholesterol Level after Treatment in Bipolar Patients.

Ji Min NAM ; Tae Suk KIM ; Jung Jin KIM ; Chang Uk LEE ; Soo Jung LEE ; Chul LEE ; In Ho PAIK ; Chi Un PAE

Korean Journal of Psychopharmacology.2005;16(6):507-512.

OBJECTIVES: Cholesterol interacts with serotonin and it has been found to be associated with some clinical symptoms of mood disorders. There is a paucity of data on first onset bipolar patients and from Asian population. In this study, we compared the total choelsterol (TC) level between the bipolar I patients with a single manic episode (BPSM) and the normal controls, and investigated the relationship between the TC level and treatment response in the BPSM. METHODS: Twenty-five BPSM and thirty normal controls were enrolled in this study. The pretreatment and posttreatment TC levels in the BPSM were measured and comapred to that of normal controls. Young Mania Rating Scale (YMRS) was used for assessing symptom severity in the BPSM. RESULTS: The TC level was significantly lower in the BPSM than in the controls. There were negative correlations between the YMRS scores and the pretreatment TC level in the BPSM. The posttreatment TC level was significantly higher than the pretreatment TC level in the BPSM. CONCLUSION: This study suggests that the TC level can be changed after treatment in bipolar manic patients, although more studies involving different ethnic groups will be needed. Further longitudinal studies will be needed to examine the change of total cholesterol level according to the clinical course of bipolar disorder.
Asian Continental Ancestry Group ; Bipolar Disorder ; Cholesterol* ; Ethnic Groups ; Humans ; Mood Disorders ; Serotonin

Asian Continental Ancestry Group ; Bipolar Disorder ; Cholesterol* ; Ethnic Groups ; Humans ; Mood Disorders ; Serotonin

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Subjective Response to Antipsychotics in Acute Manic Patients.

Bo Hyun YOON ; Won Myong BAHK ; Duk In JON ; Chan Hyung KIM ; Hyun Sang CHO ; Young Chul SHIN ; Kyung Joon MIN

Korean Journal of Psychopharmacology.2005;16(6):498-506.

OBJECTIVE: It is well-known that antipsychotics are widely used in the treatment of bipolar disorder. So, the aim of this study was to examine the subjective response to antipsychotics in acute manic patients. METHODS: Data were gathered through the study for feasibility testing of Korean Medication Algorithm for Bipolar Disorder (KAMP-BP), which 17 nationwide clinical centers were entered into the study. A total 126 bipolar patients were enrolled and then 92 were treated according to the treatment algorithm. The data of 58 patients were completely recorded from baseline to 2 weeks of treatment and were entered into analysis. Drug Attitude Inventory-10 (DAI-10) was used for evaluating patient's subjective response to antipsychotics and patients were grouped as subjective non-dysphoric and dysphoric as the total score of DAI-10. For assessing the clinical status, Young Mania Rating Scale (YMRS), Clinical Global Impression- Severity scale (CGI-S), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF) and Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) were used. RESULTS: Dysphoric group was younger and has more females in sex distribution than non-dysphoric group. YMRS and CGI-S were severer in dysphoric group. The prescription patterns were not different between two groups: Combinations of mood stabilizers and antipsychotics were administered to all patients and atypical antipsychotics were prescribed over 90% of the patients. At 2 weeks of treatment, more patients were turned into remission in non-dysphoric group. Dysphoric patients showed more changes of positive subjective response in DAI-10 from baseline and more patients turned toward the non-dysphoric group. CONCLUSION: Although the subjective response to antipsychotics using DAI-10 was not typically characterized in acute manic patients, it seems that atypical antipsychotics may have a role in determining the subjective feelings of the acute bipolar manic patients.
Antipsychotic Agents* ; Bipolar Disorder ; Depression ; Female ; Humans ; Prescriptions ; Sex Distribution

Antipsychotic Agents* ; Bipolar Disorder ; Depression ; Female ; Humans ; Prescriptions ; Sex Distribution

Country

Republic of Korea

Publisher

Korean College of Neuropsychopharmacology

ElectronicLinks

http://journal.kcnp.or.kr/

Editor-in-chief

E-mail

Abbreviation

Korean J Psychopharmacol

Vernacular Journal Title

대한정신약물학회지

ISSN

1017-5717

EISSN

2092-5700

Year Approved

2007

Current Indexing Status

Currently Indexed

Start Year

1990

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