Acute Manic Relapse with Dexfenfluramine.
Clinical Psychopharmacology and Neuroscience.2011;9(1):44-44.
Clinical Psychopharmacology and Neuroscience
2003 to Present ISSN: 1738-1088
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Clinical Psychopharmacology and Neuroscience.2011;9(1):36-43.
OBJECTIVE: Aripiprazole, a dopamine system stabilizer, shows efficacy against both negative symptoms and positive symptoms in patients with schizophrenia. The aim of this study was to investigate the effects of aripiprazole and haloperidol on c-FOS expression in rat brain. METHODS: Aripiprazole (1, 10 and 30 mg/kg, i.p.) and haloperidol (0.1 and 1 mg/kg, i.p.) were administered to adult Male Sprague-Dawley rats. After 2 h of drug or vehicle administration, the rats were killed and their brains were removed and perfused with fixative, then cut into 40 microm slices on a freezing microtome. Brain regions of interest were the medial prefrontal cortex (mPFC), the nucleus accumbens core and shell (NAC-C and NAC-S), the hippocampus (CA1, CA3 and DG), the central amygdala (Ce), the basolateral amygdala (BL) and the temporal cortex (Tc). Immunohistochemistry was performed to label cell bodies containing c-FOS. RESULTS: The administration of aripiprazole at all doses (1, 10 or 30 mg/kg) resulted in greater Fos-like immunoreactivity (FLI) in the investigated brain areas, as compared to the vehicle. Comparable increases in FLI were demonstrated in the NAC-C and NAC-S in response to both aripiprazole and haloperidol treatment. The administration of haloperidol (0.1 or 1 mg/kg) also resulted in greater FLI in the investigated brain areas, except the mPFC, where no changes were observed. In the Ce and BL, a significant increase in Fos-positive neurons was observed only with 0.1 mg/kg of haloperidol. CONCLUSION: Both aripiprazole and haloperidol increased FLI in limbic areas, which are considered important targets of antipsychotic drugs. The differential action of aripiprazole on FLI in the amygdala and mPFC as compared to haloperidol may be a good way to differentiate atypical from typical antipsychotics.
Adult ; Amygdala ; Animals ; Antipsychotic Agents ; Brain ; Dopamine ; Freezing ; Haloperidol ; Hippocampus ; Humans ; Immunohistochemistry ; Male ; Neurons ; Nucleus Accumbens ; Piperazines ; Prefrontal Cortex ; Quinolones ; Rats ; Rats, Sprague-Dawley ; Schizophrenia ; Aripiprazole
Adult ; Amygdala ; Animals ; Antipsychotic Agents ; Brain ; Dopamine ; Freezing ; Haloperidol ; Hippocampus ; Humans ; Immunohistochemistry ; Male ; Neurons ; Nucleus Accumbens ; Piperazines ; Prefrontal Cortex ; Quinolones ; Rats ; Rats, Sprague-Dawley ; Schizophrenia ; Aripiprazole
Clinical Psychopharmacology and Neuroscience.2011;9(1):29-35.
OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of methylphenidate HCL OROS extended-release (OROS-MPH) among children with attention deficit hyperactivity disorder (ADHD) who had been previously treated with methylphenidate HCL immediate-release (MPH-IR). METHODS: The sample included 102 children aged 6-12 (9.4+/-2.6) years who had been diagnosed with ADHD according the criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV; American Psychiatric Association, 1994) and who were attending seven centers in Korea. All participants had been medicated with a stable dose of MPH (10-60 mg/day) for at least 3 weeks before entry into the study. Doses of OROS-MPH were comparable to daily doses of MPH. Efficacy was assessed at baseline (day 0) and at day 28 with the Inattentive-Overactive with Aggression (IOWA) Conners Rating Scale, which was completed by parents/caregivers and teachers, the Peer Interaction Rating Items, which were completed by teachers, and the Clinical Global Impression (CGI) scale, which was completed by child psychiatrists. Paired t-tests were used, and P-values were set at the 0.05 level. RESULTS: Of the subjects, 92.2% were boys and 79.4% were students in the first to fourth grades of elementary school. 72% were diagnosed with the combined type of ADHD, 23% were diagnosed with the inattentive type, and 5% were diagnosed with the hyperactive-impulsive type. The results of the parents' responses to the Inattention/Hyperactivity (I/H) and Oppositional/Defiant (O/D) subscales of the IOWA Conners scale indicated statistically significant improvement in childrens behavior after 4 weeks of treatment with OROS-MPH (t=6.28, p<.001, t=4.12, p<.001). However, the teachers' responses to the Conners I/H and O/D subscales indicated no significant improvement at 4 weeks. The teachers also reported no significant improvements under the OROS-MPH compared with the MPH-IR condition with respect to peer interactions. Scores on the CGI scale showed that 46.1% of children with ADHD were rated by psychiatrists as "minimally improved", 27.5% as "much improved," 1.0% as "very much improved," 3.9% as "minimally worse," and 16.7% as showing "no change". Children exhibited significantly fewer tics with OROS-MPH treatment than with MPH-IR treatment (19.6% vs. 27.7%). We found no differences between in sleep and appetite problems according to medication. CONCLUSION: The results of this study indicated that an MPH-IR regimen can be successfully changed to a once-daily OROS-MPH regimen without any serious adverse effects. The changes in parent/caregiver IOWA Conners ratings suggested that OROS-MPH improved the control of symptoms after school, a finding that is consistent with the 12-h duration of action of this medication. Because the therapeutic effect of OROS-MPH is sufficiently longer than that of a b.i.d. dose of MPH-IR, OROS-MPH had significant positive effects on oppositional/defiant behavior in addition to its effects on the core symptoms of ADHD.
Aged ; Aggression ; Appetite ; Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Iowa ; Korea ; Methylphenidate ; Phenazines ; Psychiatry ; Tics
Aged ; Aggression ; Appetite ; Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Iowa ; Korea ; Methylphenidate ; Phenazines ; Psychiatry ; Tics
Clinical Predictors of Drug Response in Patients with Obsessive-Compulsive Disorder.
Clinical Psychopharmacology and Neuroscience.2011;9(1):23-28.
OBJECTIVE: The aim of this study was to evaluate which clinical variables might influence the antiobsessional responses to proserotonergic drugs in a sample of patients with obsessive-compulsive disorder (OCD). METHODS: Two hundred forty-nine patients with DSM-IV OCD under-gone mean 13-month treatments with selective serotonin reuptake inhibitors. According to the treatment response, defined as a reductions of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score > or =35%, patients were divided into two groups. RESULTS: One hundred fourteen patients responded to the treatment and the other one hundred thirty five patients did not. Responders had a significant long duration of medication in YUMC OCD clinic, short total duration of past treatment in other institutes, and higher frequency of drug naive cases and lower baseline Y-BOCS scores. CONCLUSION: The pre-treatment factors including total duration of past treatment, drug naive or not, baseline OCD symptoms and the factor of duration of the treatment may influence drug treatment response in OCD patients.
Academies and Institutes ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Obsessive-Compulsive Disorder ; Serotonin Uptake Inhibitors
Academies and Institutes ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Obsessive-Compulsive Disorder ; Serotonin Uptake Inhibitors
Clinical Psychopharmacology and Neuroscience.2011;9(1):17-22.
OBJECTIVE: Although the standard of treatment for schizophrenia is antipsychotic monotherapy, overall psychotropic polypharmacy including antipsychotic polypharmacy is increasingly practiced by clinicians. However, there are very few studies that assess the prescription patterns of psychotropic drugs for patients with schizophrenia in Korea. The objective of this study is to describe changes in prescription patterns with respect to antipsychotic polypharmacy and overall psychotropic polypharmacy. METHODS: In this retrospective study, we reviewed all psychotropic drugs prescribed at the time of discharge for patients diagnosed as having schizophrenia (DSM-IV criteria) who entered a psychiatric unit of a Korean general hospital from 2001 to 2008. These included a total of 467 patients. RESULTS: Of the 467 patients in this study, 205 (43.9%) were discharged with antipsychotic monotherapy and the rest, 262 (56.1%), were discharged with a polypharmacy regimen. A total of 9% of the studied patients received more than two antipsychotic drugs. The most frequent combination of antipsychotics was clozapine and aripiprazole, followed by clozapine and amisulpride, and risperidone and olanzapine. The ratio of patients discharged with a polypharmacy regimen including antipsychotic polypharmacy increased from 2001 to 2008. In relation to the mean dose of all antipsychotic drugs at the time of discharge, mean length of hospital stay and mean initial global assessment of functioning scores on admission statistically significant differences were not detected between both monotherapy and polypharmacy groups. CONCLUSION: The main finding of this study is that polypharmacy with antipsychotics and other psychotropic medicines increased in our psychiatric unit from 2001 to 2008. The rates of antipsychotic polypharmacy in our study were less than those described in our literature review.
Antipsychotic Agents ; Benzodiazepines ; Clozapine ; Hospitals, General ; Humans ; Korea ; Length of Stay ; Piperazines ; Polypharmacy ; Prescriptions ; Psychotropic Drugs ; Quinolones ; Retrospective Studies ; Risperidone ; Schizophrenia ; Sulpiride ; Aripiprazole
Antipsychotic Agents ; Benzodiazepines ; Clozapine ; Hospitals, General ; Humans ; Korea ; Length of Stay ; Piperazines ; Polypharmacy ; Prescriptions ; Psychotropic Drugs ; Quinolones ; Retrospective Studies ; Risperidone ; Schizophrenia ; Sulpiride ; Aripiprazole
Central Nervous System Drug Evaluation Using Positron Emission Tomography.
Clinical Psychopharmacology and Neuroscience.2011;9(1):9-16.
In conventional pharmacological research in the field of mental disorders, pharmacological effect and dose have been estimated by ethological approach and in vitro data of affinity to the site of action. In addition, the frequency of administration has been estimated from drug kinetics in blood. However, there is a problem regarding an objective index of drug effects in the living body. Furthermore, the possibility that the concentration of drug in blood does not necessarily reflect the drug kinetics in target organs has been pointed out. Positron emission tomography (PET) techniques have made progress for more than 20 years, and made it possible to measure the distribution and kinetics of small molecule components in living brain. In this article, we focused on rational drug dosing using receptor occupancy and proof-of-concept of drugs in the drug development process using PET.
Brain ; Central Nervous System ; Drug Evaluation ; Electrons ; Kinetics ; Mental Disorders ; Norepinephrine Plasma Membrane Transport Proteins ; Positron-Emission Tomography ; Receptors, Dopamine D2 ; Serotonin Plasma Membrane Transport Proteins
Brain ; Central Nervous System ; Drug Evaluation ; Electrons ; Kinetics ; Mental Disorders ; Norepinephrine Plasma Membrane Transport Proteins ; Positron-Emission Tomography ; Receptors, Dopamine D2 ; Serotonin Plasma Membrane Transport Proteins
Tardive Dyskinesia: Treatment with Aripiprazole.
Clinical Psychopharmacology and Neuroscience.2011;9(1):1-8.
Tardive dyskinesia is characterized by choreiform movements, or rhythmic abnormal involuntary movements of the face, mouth, tongue, trunk, and limbs. It is frequently associated with the use of neuroleptic medications. The choreiform movements are irreversible in some patients, even after the drug is withdrawn. Although no reliable treatment for tardive dyskinesia exists, atypical antipsychotics are associated with a significantly lower incidence of tardive dyskinesia than typical antipsychotics. Moreover, recent reports suggest that atypical antipsychotics may have a beneficial effect on tardive dyskinesia remission. Until recently, evidence for the effectiveness of aripiprazole on tardive dyskinesia has been mixed. Aripiprazole has a unique mechanism of action and has various effects in tardive dyskinesia. The drug acts as a partial D2 receptor agonist that can stabilize D2 up-regulation, and as a partial 5-HT1A receptor agonist and a 5-HT2A receptor antagonist, and can increase the release of dopamine in the striatum.
Antipsychotic Agents ; Chorea ; Dopamine ; Dyskinesias ; Extremities ; Humans ; Incidence ; Mouth ; Movement Disorders ; Piperazines ; Quinolones ; Receptor, Serotonin, 5-HT1A ; Receptor, Serotonin, 5-HT2A ; Tongue ; Up-Regulation ; Aripiprazole
Antipsychotic Agents ; Chorea ; Dopamine ; Dyskinesias ; Extremities ; Humans ; Incidence ; Mouth ; Movement Disorders ; Piperazines ; Quinolones ; Receptor, Serotonin, 5-HT1A ; Receptor, Serotonin, 5-HT2A ; Tongue ; Up-Regulation ; Aripiprazole
Clinical Psychopharmacology and Neuroscience.2017;15(3):298-299. doi:10.9758/cpn.2017.15.3.298
Clinical Psychopharmacology and Neuroscience.2017;15(3):296-297. doi:10.9758/cpn.2017.15.3.296
Codeine Precipitating Serotonin Syndrome in a Patient in Therapy with Antidepressant and Triptan.
Clinical Psychopharmacology and Neuroscience.2017;15(3):292-295. doi:10.9758/cpn.2017.15.3.292
The serotonin syndrome is a serioius medical condition due due to an intensive stimulation of setonin receptors. It is a rare, but severe, consequence of interaction between serotomimetic agents. This is a report of a 70-year-old woman steadily in therapy with venlafaxine and rizatriptan for migraine and major depressive syndrome. She was admitted to neurology unit for decreased light reflex with miotic pupils, global hyperreflexia, tremor, anxiety, ataxia and incoordination. The patient was diagnosed as a probable case of serotonin syndrome due to a pharmacological interaction between venlafaxine and rizatriptan trigged by opioid intake. In this paper, the development of syntomatology, the clinical examination and the possible pharmacokinetics explanation were carefully discussed and analysed.
Aged ; Anxiety ; Ataxia ; Codeine* ; Depressive Disorder ; Depressive Disorder, Major ; Female ; Humans ; Migraine Disorders ; Neurology ; Pharmacokinetics ; Prescription Drug Misuse ; Pupil ; Reflex ; Reflex, Abnormal ; Serotonin Syndrome* ; Serotonin* ; Tremor ; Venlafaxine Hydrochloride
Aged ; Anxiety ; Ataxia ; Codeine* ; Depressive Disorder ; Depressive Disorder, Major ; Female ; Humans ; Migraine Disorders ; Neurology ; Pharmacokinetics ; Prescription Drug Misuse ; Pupil ; Reflex ; Reflex, Abnormal ; Serotonin Syndrome* ; Serotonin* ; Tremor ; Venlafaxine Hydrochloride
Country
Republic of Korea
Publisher
Korean College of Neuropsychopharmacology
ElectronicLinks
http://www.cpn.or.kr/Editor-in-chief
Young-Chul Chung
secretariat@kcnp.or.kr
Abbreviation
Clin Psychopharmacol Neurosci
Vernacular Journal Title
ISSN
1738-1088
EISSN
2093-4327
Year Approved
2012
Current Indexing Status
Currently Indexed
Start Year
2003
Description
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