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주요 우울증에서 Interleukin-10 유전자의 제한효소 절편길이 다형성
전태연,배치운,이정태,박원명,김광수,Jun, Taeyoun,Pae, Chi-Un,Lee, Chung Tai,Bahk, Won-Myong,Kim, Kwang-Soo 대한생물정신의학회 2000 생물정신의학 Vol.7 No.2
Objective : Major depression is known to have immunologic dysfunctions, the recent studies revealed that cytokines including IL-6 and IL-$1{\beta}$ were increased in patients with major depression. Since molecular genetic methods have been progressed, this study was to investigate the relationship between major depression and immunologic aspects by analyzing polymorphism of IL-10 gene. Method : 92 patients with major depression were included and data of 146 normal controls obtained from the Catholic Hemopoietic Stem Cell Information Bank of Korea were used in this study. DNA was extracted from whole blood, thereafter amplified by polymerase chain reaction, and digested by Mae III After that procedure, we obtained and assessed RFLP of two alleles, IL-10T and IL-10C. All data were analyzed by ${\chi}^2$ test. Results : 1) There were no significant difference in genotype frequencies of $IL-10^*T/T$, $IL-10^*T/C$, and $IL-10^*C/C$ between major depression patients group and control group. 2) There were no significant difference in allelic frequencies of $IL-10^*T$ and $IL-10^*C$ between major depression patients group and control group. Conclusion : We did not verified the differences in frequencies of $IL-10^*T/^*IL-10^*C$ gene between the major depression patients group and control group, respectively. But the results of this study do not declare that the IL-10 gene has no association with major depression. We do suggest that further systematic studies including various clinical variables should be conducted.
Sheng-Min Wang,Nak-Young Kim,Hae-Ran Na,Hyun Kook Lim,Young Sup Woo,Chi-Un Pae,Won-Myong Bahk 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.2
Objective: We performed a meta-analysis of randomized double-blinded placebo controlled trials (DB-RCTs) to inves-tigate efficacy and safety of intranasal esketamine in treating major depressive disorder (MDD) including treatment re-sistant depression (TRD) and major depression with suicide ideation (MDSI). Methods: Mean change in total scores on Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline to differ-ent time-points were our primary outcome measure. Secondary efficacy measures included rate of remission of depres-sion and resolution of suicidality. Results: Eight DB-RCTs (seven published and one un-published) covering 1,488 patients with MDD were included. Esketamine more significantly improved MADRS total scores than placebo starting from 2−4 hours after the first admin-istration (standardized mean difference, −0.41 [95% CI, −0.58 to −0.25], p < 0.00001), and this superiority main-tained until end of double-blinded period (28 days). Sub-group analysis showed that superior antidepressant effects of esketamine over placebo in TRD and MDSI was observed from 2−4 hours, which was maintained until 28 days. Resolution of suicide in MDSI was also greater for esketamine than for placebo at 2−4 hours (OR of 2.04, 95% CIs, 1.37 to 3.05, p = 0.0005), but two groups did not statistically differ at 24 hours and day 28. Total adverse events (AEs), and other common AEs including dissociation, blood pressure increment, nausea, vertigo, dysgeusia, dizziness, and somnolence were more frequent in esketamine than in placebo group. Conclusion: Esketamine showed rapid antidepressant effects in patients with MDD, including TRD and MDSI. The study also suggested that esketamine might be associated with rapid anti-suicidal effects for patients with MDSI.
Informa UK, Ltd. 2012 Expert opinion on pharmacotherapy Vol.13 No.18
<P>A number of different antidepressants, each with unique pharmacological profiles, are used for treatment of major depressive disorder (MDD); however, these drugs have been found in placebo-controlled, large practical clinical trials to have limited efficacy for achieving full recovery in MDD patients. In particular, when depressed patients have pain symptoms, their chance of remission is significantly decreased. Pain also often leads to residual symptoms and incomplete functional recovery. Hence, while pain should be a principal target symptom in patients with MDD, there continues to be unmet need for pain treatment in depressed patients. Therefore, more diverse options for treatment approaches can be expected to enhance outcomes in clinical treatment of depressed patients with comorbid pain. In this context, Dr. Romera and colleagues have investigated an early antidepressant-switching strategy in patients with initial treatment failure. They found that early switching to a different antidepressant in MDD patients with moderate-to-severe symptoms of physical pain seems to lead to better pain and functional outcomes. This article discusses clinical significance, practical issues, potential limitations, and future research implications based on the findings from Dr. Romera and colleagues' study.</P>
No influence of FAT polymorphisms in response to aripiprazole.
Pae, Chi-Un,Chiesa, Alberto,Mandelli, Laura,De Ronchi, Diana,Serretti, Alessandro Springer-Verlag 2010 Journal of human genetics Vol.55 No.1
<P>The aim of this study was to investigate possible influences of a set of markers in the FAT gene (rs2306987, rs2306990, rs2637777 and rs2304865) on efficacy and tolerability of aripiprazole in the treatment of schizophrenic patients. Efficacy was assessed at baseline and weeks 1, 2, 4, 6, 8 and 12 using the Clinical Global Impression Severity and Improvement scale (CGI-S; CGI-I), the Brief Psychiatric Rating Scale and the Schedule for the Assessment of Negative Symptoms scale. Side effects were evaluated by means of the Simpson-Angus Scale for Extrapyramidal Symptoms, the Barnes Akathisia Scale and the Abnormal Involuntary Movement Scale. Multivariate analyses were employed to test possible influences of single nucleotide polymorphisms on clinical and safety variables. Analysis of haplotypes was also performed. No relevant association between FAT variants and clinical or safety scores was observed. Haplotype analysis did not reveal any significant association with clinical and safety scores at any time as well. Our data suggest no association between investigated alleles and genotypes in FAT and response to aripiprazole. However, because several limitations characterize the present study, further investigations on larger studies are required.</P>
Chi-Un Pae,Changsu Han,Won-Myong Bahk,Soo-Jung Lee,Ashwin A. Patkar,Prakash S. Masand 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.2
Objective: In a number of controlled clinical trials and naturalistic studies, aripiprazole once monthly (AOM) has been found to be effective and safe as acute and maintenance treatment options for schizophrenia. However, such clinical data have been presented in selected patient population (i.e., antipsychotic monotherapy, etc.), in particular, clinical information on switching to AOM from antipsychotic polypharmacy and/or other long acting injectable antipsychotics (LAIs) has been scarce till today. Methods: The study period was from the first switching day to AOM up to 12 months in patients with antipsychotic polypharmacy (APpoly)/LAIs (baseline, month 3, month 6, and month 12). Available demographics and clinical in-formation were retrieved from electronic medical records (EMRs). Available scores of Global Assessment of Functioning (GAF), Clinical Global Impression-Clinical Benefit (CGI-CB), CGI-severity, Visual Analog Scale on Satisfaction-Patient/Health Professional (VAS-P/HP), and the Positive and Negative Syndrome Scale-Insigh (PANSS-I) scores were also taken from EMR. Proportional change of functional impairment before and after AOM was also captured. Results: Data of 18 patients were available. Most commonly used combined APs before AOM were aripiprazole, blo-nanserin, quetiapine, and risperidone. At least 2 APs (n = 2.4) were combined before AOM. Scores of GAF (10.7% increase), CGI-CB (46.2% decrease), VAS-P (47.8% increase), VAS-HP (40.8% increase), and PANSS-I (27.9% increase) (all p = 0.001) were significantly improved from baseline to month 12, respectively. Approximately 59% of patients improved individual functioning with different level (i.e., employment, back to school, etc.) after AOM treatment at month 12. Conclusion: The present study have clearly shown the clinical benefit and utility of switching to AOM for treatment of patients with APpoly/LAIs in routine practice. Subsequent, adequately-powered, well-controlled clinical trials may be necessary to confirm our findings in near future.
Aripiprazole augmentation for treatment of patients with inadequate antidepressants response
Pae, Chi-Un,Patkar, Ashwin A.,Jun, Tae-Youn,Lee, Chul,Masand, Prakash S.,Paik, In-Ho Wiley Subscription Services, Inc., A Wiley Company 2007 Depression and Anxiety Vol.24 No.7
<P>This study evaluated whether or not augmentation with aripiprzazole is beneficial and tolerable to patients with an inadequate response to antidepressants (ADs). Thirteen patients with nonpsychotic major depression, who had failed to respond to an adequate trial of at least one AD, were prescribed aripiprazole (dose, 5–30 mg) for 8 weeks. The dose of their preexisting ADs was not changed. The treatment response was defined as the mean changes in the scores of the Hamilton Depression Rating Scale (HAM-D) from the baseline to the end of treatment. Eleven (84.6%) patients returned for at least one follow-up visit, and 7 (53.8%) patients completed the study. The HAM-D and Clinical Global Impression—Severity (CGI-S) scores decreased significantly from the baseline to the end of treatment by 53.8% and 56.0%, respectively (Z = −2.937, P =.003; Z = −2.961, P =.003). Seven (63.6%) patients showed a ≥ 50% reduction in the HAM-D score at the end of treatment. Three (27.3%) patients met the remission criteria at the end of treatment. There were no serious side effects. Despite the high dropout rate in this open study, aripiprazole appears to be reasonably effective and tolerated as an augmentation strategy in conjunction with conventional ADs treatment in patients with an inadequate AD response. These results highlight the potential benefits of aripiprazole for these patients. However, adequately powered, randomized, controlled trials are needed to confirm these results. Depression and Anxiety 24:522–526, 2007. © 2006 Wiley-Liss, Inc.</P>
Pae, Chi-Un,Wang, Sheng-Min,Han, Changsu,Lee, Soo-Jung,Patkar, Ashwin A,Masand, Praksh S,Serretti, Alessandro Journal of Psychiatry and Neuroscience] 2015 JOURNAL OF PSYCHIATRY AND NEUROSCIENCE Vol.40 No.3
<P>Vortioxetine was approved by the U.S. Food and Drug Administration (FDA) in September 2013 for treating major depressive disorder (MDD). Thus far, a number of randomized, double-blind, placebo-controlled clinical trials (RCTs) of vortioxetine have been conducted in patients with MDD. We performed a meta-analysis to increase the statistical power of these studies and enhance our current understanding of the role of vortioxetine in the treatment of MDD.</P>