Korean Medication Algorithm Projects for Major Psychiatric Disorders(I) : The Genefit and Risk of Algorithm and the General Considerations of Developing Medication Algorithm / 대한정신약물학회지

The rapid development of psychotropic drugs and great advancement in psychopharmacology during the past recent years has altered the strategy of pharmacotherapy for major psychiatric disorders, and in turn, an active development of various clinical practice guidelines or algorithm has taken place. However, there could be problems with applying the foreign guidelines directly to our clinical situation, due to the differences in racial characteristics, socioeconomic conditions, government policy, and clinical practices. In addition, the changes of circumstances outside of clinical situation in Korea may distort clinical practices and may go even against the trend of recent psychopharmacology. As a solution to such problems, Korean Medication Algorithm Project for Major Psychiatric Disorders (KMAP) was launched with the support from the Korean Society of Psychopharmacology and Korean Academy of Schizophrenia. However, since clinical practice guidelines and algorithms contain not only the advantages, but also disadvantages and risks, sufficient consideration must precede the development of algorithms. Hence, this review provides a discussion on the definition of clinical guideline and its limitation, its advantages and disadvantages, and the need for the development of clinical guideline in psychiatric field. Also, developing source, dissemination and implementation of clinical practice guidelines were also discussed. We hope that this review can make the purpose of KMAP clear and elicit the productive criticism on Korean algorithm.

Atenolol Induced Visual Hallucination in Patients with Underlying cerebral Infarction / 대한정신약물학회지

Atenolol is a beta1-selective adrenoreceptor blocking agent which is generally thought of as cardioselective, with little CNS action, because it has hydrophilic solubility rather than lipophilic. But recently, it has been reported that atenolol also can cause CNS side effect, especially in the patient with past neuropsychiatric history, old age, or underlying cerebral lesion. This 59-year-old female case demonstrated that atenolol could be an etiological agent of visual hallucination in a elderly patient with cerebral infarction.