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      • KCI등재

        A Systemic Review and Experts’ Consensus for Long-acting Injectable Antipsychotics in Bipolar Disorder

        Yuan-Hwa Chou,Po-Chung Chu,Szu-Wei Wu,Jen-Chin Lee,Yi-Hsuan Lee,I-Wen Sun,Chen-Lin Chang,Chien-Liang Huang,I-Chao Liu,Chia-Fen Tsai,Yung-Chieh Yen 대한정신약물학회 2015 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.13 No.2

        Bipolar disorder (BD) is a major psychiatric disorder that is easily misdiagnosed. Patient adherence to a treatment regimen is of utmost importance for successful outcomes in BD. Several trials of antipsychotics suggested that depot antipsychotics, including long-acting first- and second-generation agents, are effective in preventing non-adherence, partial adherence, and in reducing relapse in BD. Various long-acting injectable (LAI) antipsychotics are available, including fluphenazine decanoate, haloperidol decanoate, olanzapine pamoate, risperidone microspheres, paliperidone palmitate, and aripiprazole monohydrate. Due to the increasing number of BD patients receiving LAI antipsychotics, treatment guidelines have been developed. However, the clinical applicability of LAI antipsychotics remains a global cause for concern, particularly in Asian countries. Expert physicians from Taiwan participated in a consensus meeting, which was held to review key areas based on both current literature and clinical practice. The purpose of this meeting was to generate a practical and implementable set of recommendations for LAI antipsychotic use to treat BD; target patient groups, dosage, administration, and adverse effects were considered. Experts recommended using LAI antipsychotics in patients with schizophrenia, rapid cycling BD, BD I, and bipolar-type schizoaffective disorder. LAI antipsychotic use was recommended in BD patients with the following characteristics: multiple episodes and low adherence; seldom yet serious episodes; low adherence potential per a physician’s clinical judgment; preference for injectable agents over oral agents; and multiple oral agent users still experiencing residual symptoms.

      • KCI등재후보

        Simultaneous Measurement of Dopamine Transporters and D2/D3 Receptors in Drug Naïve Schizophrenic Patients

        Yuan-Hwa Chou,Wen-Sheng Huang,Ju-Wei Hsu,Shin-Min Lee,An-Shoei Yang,Kai-Chun Yang 대한정신약물학회 2010 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.8 No.2

        Objective: Previous single photon emission computed tomography (SPECT) studies have demonstrated that co-injection of radiotracers 99mTc-TRODAT and 123IBZM can assess both presynaptic, dopamine transporters (DATs), and postsynaptic, dopamine D2/D3 receptors, markers of dopaminergic system simultaneously. The aim of this study was to determine both DATs and dopamine D2/D3 receptors in drug naïve schizophrenic patients. Methods: Severn drug naïve schizophrenic patients and eleven age-matched healthy controls were recruited. Each subject received one SPECT measurement after intravenous co-administration of 99mTc-TRODAT and 123IBZM and one brain MRI scan. A ratio equilibrium model was applied to calculate the specific uptake ratio (SUR) which corresponds to the ratio of Bmax (receptor density) and KD (affinity). Results: The results showed that the SUR of DATs binding was not significantly different between healthy controls and drug naïve schizophrenic patients (2.92±0.62 vs. 2.65±0.27, p=0.052) and, however, the SUR of dopamine D2/D3 receptors binding was significantly lower in drug naïve schizophrenic patients than those in healthy controls (2.79±0.54 vs. 3.90±0.58, p=0.001). Additionally, there was a significant correlation between left and right binding for both DATs (r=0.80, p=0.003) and dopamine D2/D3 receptors (r=0.96, p=0.000) in healthy controls but not seen in drug naïve schizophrenic patients (r=0.54, p=0.20 for DATs, r=0.70, p=0.08 for dopamine D2/D3 receptors). Conclusion: This study provides evidences to support the idea that abnormalities of dopaminergic system in schizophrenia and further elucidates the disruption of inter-hemispheric interaction of postsynaptic and presynaptic markers.

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