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정신분열병 환자의 임신 전 기간 Risperdal Consta 사용 사례
선우영경,김지영,배재남,김철응 대한정신약물학회 2006 대한정신약물학회지 Vol.17 No.6
Long acting noble antipsychotic, Risperdal Consta, has been reported to be efficacious and well tolerated in treatment of schizophrenia. However there was no report about the safety in using during pregnancy. Here we present the case of female patient with schizophrenia treated with risperdal consta during the entire period of pregnancy and delivered normal child. This case report highlights the benefit/risk of risperdal consta during pregnancy.
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선우영경,이상헌,강민희,김철응,이정섭,배재남 대한정신약물학회 2007 대한정신약물학회지 Vol.18 No.3
We describe a young male patient with rhabdomyolysis associated with the use of the atypical antipsychotic medication ziprasidone. A 23-year-old male was diagnosed with psychotic disorder not otherwise specified and treated with ziprasidone 120 mg/day. On hospital day 6, the patient developed acute dystonia. On day 8, his serum creatine kinase (CK) level was markedly elevated (up to 53,880 IU/L) and the white blood cell count was 10,500 cells/L. No other diagnostic criteria for neuroleptic malignant syndrome (NMS) were present. On discontinuation of the drug, serum CK concentrations returned to normal within 10 days. Atypical NMS should be considered when patients who are treated with novel atypical antipsychotics develop isolated serum CK elevation. 상기 증례의 경우 환자가 젊은 남성이고, 항정신병약물의 빠른 용량 증가가 신경악성증후군 위험 요인으로 추론된다. 따라서 비정형 항정신병약물 치료 시작 시기에 신경악성증후군의 위험 요인을 가진 환자들에서 혈청 CK 수치를 확인하는 것이 필요하며, 조기 발견과 적극적인 치료를 하는 것이 신경악성증후군으로 진행하는 것을 막을 수 있을 것이다. 앞으로 새로운 비정형 항정신병약물의 부작용에 대한 체계적인 연구가 필요할 것으로 생각된다.
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Relationships of Mental Disorders and Weight Status in the Korean Adult Population
선우영경,배재남,함봉진,이동우,박종익,조성진,이준영,김진영,장성만,전홍진,조맹제 대한의학회 2011 Journal of Korean medical science Vol.26 No.1
The purpose of this study was to evaluate the associations between weight status and mental disorders, including depressive disorder, anxiety disorder and alcohol use disorder. A total of nationally representative 6,510 subjects aged 18-64 yr was interviewed in faceto-face household survey. Response rate was 81.7%. Mental disorders were diagnosed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The subjects reported their heights and weights. After adjusting for age and gender, the lifetime diagnosis of depressive disorder had a significant association with only the underweight group (odds ratio [OR], 1.68, 95% confidence interval [CI], 1.19-2.38). The association between underweight and depressive disorder was the strongest for subjects with a high education level (OR, 1.75, 95% CI, 1.2-2.56), subjects with a married/cohabiting status (OR, 1.94, 95% CI, 1.17-3.22) and smokers (OR, 2.58, 95% CI, 1.33-4.98). There was no significant association between obesity and depressive disorder in Korea. But there was a significant association between the underweight group and depressive disorder. The relationship between obesity and mental disorder in a Korean population was different from that in a Western population. These results suggest that the differences of traditional cultures and races might have an important effect on the associations between the weight status and mental disorders.
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Tourette 장애 소년에서 자기공명영상을 이용한 기저핵의 용적 분석
선우영경,신용범,이명지,김지영,배재남,강민희,김철응,이정섭 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.4
Objectives : The purpose of this study was to investigate the regional differences of the basal ganglia volume between the boy subjects who have Tourette's disorder and the control group who don't have this disorder by using Brain MRI. Methods : Sixteen subjects who were diagnosed as Tourette's disorder using DSM-IV criteria, and sixteen healthy subjects were selected. For analysis the coronal slice images of the basal ganglia were collected and collected MR images were analyzed with NIH Image (version 6.1 ppc). Resuls : The total brain volume in the subjects with Tourette's disorder were smaller than control group by 6.2% (F=6.2, d.f.=1, P=0.019). The right putamen volume in boys with Tourette's disorder were significant smaller than control group statistically (F=3.2, d.f.=3, P=0.040). The asymmetry (1eft>right) in the globus pallidus decreased significantly in the boys with Tourette's disorder (p=0.06) were found from this experiment. Conclusion : These findings suggest that boys with Tourette's disorder may have neuropathological abnormalities in the basal ganglia. Moreover, the present findings point out the important role of basal ganglia, especially putamen, in Patho-physiology of Tourette's disorder. More studies about the structural and functional analysis of the basal ganglia in Tourette's disorder are highly required.
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뚜렛 장애 소아를 대상으로 한 Aripiprazole 의 치료효과에 대한 8주간의 전향적 개방 연구
이명지,선우영경,강민희,김철응,배재남,이정섭 대한정신약물학회 2006 대한정신약물학회지 Vol.17 No.4
Objectives : It is postulated that since aripiprazole is a dopamine partial agonist and serotonin 2A receptor antagonist, aripiprazole may be effective in Tourette syndrome with few of extrapyramidal side effects. This open label study assessed the effectiveness of aripiprazole in children with Tourette syndrome(TS). Method : Nineteen children, aged 6 to 13 years, diagnosed with TS were participated in a 8-week open label trial. Efficacy assessments included Korean form of Yale Global Tic Severity Scale(K-YGTSS) and Clinical Global Impression scores. Safety and tolerability evaluations included extrapyramidal symptoms and effects on weight, prolactin, and corrected QT (QTc) interval. Results : A significant decrease in TS symptoms, on all scales measured, appeared in 2 weeks. Adverse effects were mild and not significant. The most frequent side effects were somnolence, light headedness and headache. Conclusions : The results of current open label trial suggests the effectiveness of aripiprazole and few of side effects in the treatment of children with TS. Double-blind, placebo-, and active comparator –controlled studies are indicated to rigorously test of the efficacy of aripiprazole in TS. 연구목적:아리피프라졸은 도파민 수용체 부분 효현제, 5-HT2A 수용체 길항제이므로 뚜렛 장애 치료에 효과적이고 추체외로의 부작용이 적을 것으로 예상된다. 본 개방 연구는 뚜렛 장애를 가진 소아들의 아리피프라졸 치료 효과를 알아보는 것을 목적으로 하였다. 방 법 :뚜렛 장애 진단을 받은 6세에서 13세의 19명을 대상으로 한 8주간의 개방 연구를 시행했다. 임상 상태 평가는 예일 틱 증상 평가 척도와 전반적인 임상 양상-뚜렛 장애로 평가 했으며 약물 안정성은 추체외로 부작용, 체중, 혈중 프로락틴 수치, 심전도 상 QT 기간을 통해 평가했다. 결 과 :약물 사용 2주 째부터 측정한 모든 척도에서 유의한 뚜렛 증상의 감소가 있었다. 약물 부작용은 기면, 어지러움, 두통의 순서였으며 모두 경한 정도였다.
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