Diverse Molecular Targets for Therapeutic Strategies in Alzheimer's Disease

Alzheimer's disease (AD) is the most common form of dementia caused by neurodegenerative process and is tightly related to amyloid beta (Abeta) and neurofibrillary tangles. The lack of early diagnostic biomarker and therapeutic remedy hinders the prevention of increasing population of AD patients every year. In spite of accumulated scientific information, numerous clinical trials for candidate drug targets have failed to be preceded into therapeutic development, therefore, AD-related sufferers including patients and caregivers, are desperate to seek the solution. Also, effective AD intervention is desperately needed to reduce AD-related societal threats to public health. In this review, we summarize various drug targets and strategies in recent preclinical studies and clinical trials for AD therapy: Allopathic treatment, immunotherapy, Abeta production/aggregation modulator, tau-targeting therapy and metabolic targeting. Some has already failed in their clinical trials and the others are still in various stages of investigations, both of which give us valuable information for future research in AD therapeutic development.

Association Analysis of Polymorphisms on Dystrobrevin Binding Protein 1 (DTNBP1) Gene with Schizophrenia in the Korean Population

OBJECTIVES: This study was designed to investigate the association of schizophrenia and P1320, P1325, P1635, P1655, P1763 and SNP A polymorphisms on dystrobrevin binding protein 1(DTNBP1) gene in Korean patients. METHODS: We analyzed P1320, P1325, P1635, P1655, P1763 and SNP A polymorphisms on DTNBP1 gene from their DNAs extracted from their blood in 388 Korean schizophrenic patients (male 198, female 190) and 372 control subjects(male 247, female 125). We compared the differences of genotype and allele distributions of the six polymorphisms on DTNBP1 gene between the Korean schizophrenic patient group and the normal control group. RESULTS: There were no statistically significant differences of genotype and allele distributions of the P1320, P1325, P1635, P1655, P1763 and SNP A polymorphisms on DTNBP1 gene between the schizophrenic patient group and the normal control group. CONCLUSION: The results of this study suggest that P1320, P1325, P1635, P1655, P1763 and SNP A polymorphism on DTNBP1 gene do not have influence on the risk of the schizophnenic in the Korean population.

No Association between Val108/158Met Polymorphism on Catechol-O-Methyl Transferase(COMT) Gene and Smooth Pursuit Eye Movement(SPEM) Abnormality in Korean Schizophrenia Patients

OBJECTIVES: We investigated the association of Val108/158Met polymorphism on catechol-O-methyl transferase(COMT) gene with smooth pursuit eye movement(SPEM) abnormality in Korean schizophrenia patients. METHODS: We measured SPEM in 217 Korean schizophrenia patients(male 116, female 101) and divided them into two groups, one was a good SPEM function group and the other was a poor SPEM function group. Then we analyzed Val108/158Met polymorphism on COMT gene. We compared the differences of genotype and allele distributions of the polymorphism on COMT gene between the two groups. RESULTS: The natural logarithm value of signal/noise ratio(Ln S/N ratio) of the good SPEM function group was 4.39+/-0.33(mean+/-s.d.) and that of poor SPEM function group was 3.17+/-0.71. There were no statistically significant differences of age and male/female ratio between the two groups. There were no significant differences of genotype or allele distributions of the Val108/158Met polymorphism on COMT gene between the two schizophrenic groups. CONCLUSIONS: The results suggest that Val108/158Met polymorphism on COMT gene is not related to SPEM function abnormality in schizophrenia.

A Validation Study of the Korean -Version of the Montgomery- Asberg Depression Rating Scale / 신경정신의학

OBJECTIVES: The Montgomery-Asberg Depression Rating Scale (MADRS) has been reported as a valid tool for the assessment of depression because it is based on the core symptoms of depression. The aim of this study is to assess the reliability, validity and psychometric properties of the Korean version of the MADRS (K-MADRS). METHODS: One hundred seven patients, including in-patients and out-patients, diagnosed as major depressive disorder according to the DSM-IV criteria were enrolled in this study. They were assessed with K-MADRS, Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Clinical Global Impression (CGI) to examine cross-validation. Statistical analysis was done using calculation of Cronbach's alpha, Spearman Correlation Coefficient and Principal Components Analysis. RESULTS: The Cronbach's alpha coefficient of K-MADRS was 0.79. And the correlations of each item with total score were statistically significant (r=0.47-0.75, p<0.001). The inter-rater reliabilities of total score (r=0.89, p<0.001) and individual score (r=0.74-0.95, p=0.001) were high. The factor analysis revealed two factors. However, the first one accounted for 39% of variance, while the second one only for 11.1%. The total score of K-MADRS showed a significant correlation with those of HDRS, BDI and CGI (r=0.82, 0.47, 0.74, respectively, p=0.001). CONCLUSION: The K-MADRS showed good reliability and validity for the assessment of severity of depressive symptoms. And it demonstrated similar psychometric properties to previous studies. The K-MADRS is an useful instrument for assessing depressive symptoms in Korea.

Association between Tardive Dyskinesia and T103C Polymorphisms of 5-HT2A Receptor Gene

OBJECTIVE: Some candidate gene polymorphisms were reported to be associated with tardive dyskinesia (TD). The aim of this study was to investigate the association of the 5-HT2A receptor gene polymorphisms with TD in Korean schizophrenic subjects. METHOD: Subjects were of 59 schizophrenic patients with TD and 60 schizophrenic patients without TD for studying of 5-HT2A receptor gene polymorphisms. TD was evaluated using the Abnormal Involuntary Movement Scale(AIMS). Genomic DNA was amplified by PCR and digestion with MspI and BsmI. RESULT: There were no statistically significant differences in the demographic variables, such as age, male to female percentage, duration of illnesses and duration of antipsychotic drug exposure between the TD group and control group. 1) T102C polymorphisms and TD Comparing the TD group and control group, the 102T/C allele was associated with a significantly increased risk for TD (chi2=5.560, df=1, p=0.018). 2) Three AIMS categories of TD and T102C genotype. There were statistically significant differences in the three AIMS categories(chi2=6.835, df=2, p=0.033). CONCLUSION: These result suggest 102T/C genotypes of the 5-HT2A receptor gene are related to the development of TD. The 102T/C genotypes were associated with significantly higher AIMS orofacial dyskinesia scores. These findings suggest that the 5-HT2A receptor gene is significantly associated with susceptibility to TD in patients with chronic schizophrenia.

Association between A-1438G Polymorphisms of 5-HT2A Receptor Promoter Gene and Tardive Dyskinesia / 대한정신약물학회지

OBJECTIVE: Tardive dyskinesia (TD) is one of the serious side effects caused by long-term treatment with neuroleptic medication. Many investigators are trying to elucidate the pathophysiological mechanism of TD, and some candidate genetic polymorphisms have been reported as associated with TD. This study investigated the association of the 5-HT2A receptor promoter gene polymorphisms with TD in Korean schizophrenic subjects. METHODS: The subjects in this study of 5-HT2A receptor gene polymorphisms were 119 schizophrenia patients, 59 with TD and 60 without. TD was evaluated by using the Abnormal Involuntary Movement Scale (AIMS). Genomic DNA was amplified by PCR and digested with MspI. RESULTS: There were no statistically significant differences in the demographic variables of age, sex ratio, duration of illness and duration of antipsychotic drug exposure between the TD and control groups. 1) A-1438G polymorphisms and TD, By comparing the TD and control groups, the -1438A/G allele was found to be associated with a significantly increased risk for TD (x2=5.560, df=1, p=0.018). 2) Three AIMS categories of TD and A-1438G genotype. There were statistically significant differences in the three AIMS categories (x2=6.835, df=2, p=0.033). CONCLUSION: These results suggest that the -1438A/G genotype of the 5-HT2A receptor gene is related to the development of TD. The -1438A/G genotypes were associated with significantly higher AIMS orofacial dyskinesia scores. These findings suggest that the 5-HT2A receptor gene is partly associated with susceptibility to TD in patients with chronic schizophrenia.

Defense Mechanism of Professors and Residents: Comparison between Medicine and Surgery Groups / 신경정신의학

The purpose of this study was to explore the difference of defense mechanisms between medicine and surgery groups, and between residents and specialists who were professors of a medical school. The author evaluated the defense mechanisms by using Ewha Defense Mechanisms Test. The author compared the defense mechanisms of medicine and surgery specialist groups who are employed by Soonchunhyang university hospital as professors in 2000, and of medicine and surgery resident groups in 1999. First, there were significant differences in mean scores of the defense mechanisms ratings. In surgery specialist group, the rate of using projection and show-off were significantly higher than those of medicine group. In resident group, show-off, passive-aggression, dissociation, somatization, acting-out and regression were significantly higher than those of specialist group. In medicine group, residents were higher than specialists in show-off, passive-aggression, acting-out and regression. But for the specialist group, the score on anticipation was higher than in the resident group. In surgery group, residents were higher than specialists in identification, rationalization and regression. In the interaction, analysis by hierarchy and field anticipation and altruism have a significant interaction effect. Second, in comparison of maturity level between the field of speciality and level of hierarchies, surgery group used more neurotic and narcissistic defense than medicine group significantly. For the level of hierarchies, residents used more immature and neurotic defense than specialists. In medicine group, residents used immature defense more than specialists, but more mature defenses were used in specialists than residents significantly. In surgery group, residents used more immature and neurotic defenses than specialists. Mature defenses have more interaction effect. This results may reflect the fact that discipline in surgery have characteristic apprentices system and more dramatical therapeutic approach. The results seem to be useful in understanding the optimal character for each speciality. In the process of selecting spescialities evaluating one's defenses and matching with the characteristics and coping mechanisms of each specialty group can be helpful.

The Study for Switching Methods to Olanzapine in Korean Schizophrenic Patients Treated with Other Antipsychotics(I): Comparison of Therapeutic Effecacy / 신경정신의학

OBJECTIVES: This randomized, multicenter, open-label, parallel clinical trial was carried to compare the therapeutic efficacy and the proportion of successful switch between 'direct switching method' and 'start-tapering switching method' when switching an antipsychotic to olanzapine. METHODS: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10 from 13 hospitals, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For 'direct switching method' group, previous antipsychotics were abruptly discontinued and 10mg of olanzapine was administered, whereas for 'start-tapering switching method' group, initially 10mg of olanzapine was administered and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20mg. The therapeutic efficacy was measured with PANSS, BPRS, and CGI-Severity. A successful switching was defined as the completion of the 6 week trial without either worsening of the symptom(i.e. CGI-S score becomes worse twice consecutively) or the exacerbation of extrapyramidal symptoms(i.e. Simpson-Angus Scale scores becomes worse). RESULTS: 103 schizophrenic patients were participated in this study. There were no differences in baseline characteristics such as the demographic variables, the severity of symptoms, the history of previous antipsychotics treatments, the dosage of olanzapine used and the compliance between two groups. The proportion of successful switch was 71.1% for "direct switching method" and 82.2% for "start-tapering switching method", and there was no significant difference between the two switching methods. Also response rates to olanzapine based on total PANSS total scores were not different between the two groups(26.9% vs. 31.1%). At the time of completion of the trial, the scores of PANSS total, PANSS subscales, CGI-S and BPRS have significantly decreased after switching to olanzapine. But the changes of all scales measuring therapeutic efficacy in both endpoint and weekly analyses were not significantly different between the two switching methods. CONCLUSION: Although this study trial has many limitations and problems as an open clinical trial, the results may suggest that there were no significant differences between the two switching methods in the therapeutic efficacy. It was also found that the additional therapeutic benefits could be obtained by switching their antipsychotics to olanzapine.

Relationship of Estrogen to Extrapyramidal Symptoms in Female Schizophrenic Patients

OBJECTIVE: It has been thought that estrogen has neuroleptic like effect in women schizophrenic patients. This study aimed to investigate neuroleptic side-effects severity in women with schizohrenia and to investigate their putative association with variations in sex steroids over menstrual cycle. Based on the estrogen theory, The author hypothesized that parkinsonian side-effects would be exacerbated when estrogen levels were high. METHOD: 26 schizophrenic women were assessed using the ESRS(Extrapyramidal Symptom Rating Scale) and estrogen analysis. Tests were conducted twice, in the mid luteal and mid follicular phase. RESULT: It was hypothesized that high level of estrogen would lead to an exacerbation of parkisonian side-effects but the results indicated that parkinsonian side effects decreased overall when estrogen levels were high. This effects were more marked for the group taking typical neuroleptics than those taking atypical neuroleptics. CONCLUSION: The results of this study suggest that estrogen and progesteron may reduce the severity of neuroleptic indeced extrapyramidal side effects over menstrual cycle in women with schizophrenia. It was concluded that estrogen has different effects on dopamine dynamics in the mesolimbic and mesostriatal pathways according to estrogen, progesteron, catecol estrogen, prolactine.

Plasma Level of Amitriptyline after Fluoxetine Addition

OBJECTIVE: The purpose of this study was to compare the plasma amitriptyline and nortriptyline level between before and after fluoxetine addition with patients who were currently taking amitriptyline. METHOD: From the inpatient and outpatient unit of Soon Chun Hyang University Hospital, Chunan, fourteen subjects who were taking amitriptyline 25mg more than 1 week at least were given fluoxetine 20mg. Before and 2 weeks after fluoxetine addition the plasma level of amitriptyline and nortriptyline are analyzed simultaneously by High Performance Liquid Chromatography(HPLC) At the same times, HAM-D(Hamilton Rating Scale for Depression) score and the UKU(Uldvalg for Klinske Unders phi gelser) side effect scale were checked. RESULTS: After fluoxetine addition to the patients who were taking amitriptyline, the plasma level of amitriptyline, nortriptyline and sum of amitriptyline and nortriptyline had risen. The mean plasma amitriptyline level increased from 168.9+/-89.4ng/ml to 183.0+/-102.0ng/ml after fluoxetine addition(p=0.011) but the change was not statistically significant. The mean plasma nortriptyline level increased significantly from 114.3+/-70.2ng/ml to 168.0+/-86.2ng/ml after fluoxetine addition(p=0.011) In addition, the mean plasma level of total amitriptyline and nortriptyline increased significantly from 283.1+/-125.3ng/ml to 350.9+/-78.4ng/ml after fluoxetine addition(p=0.016) After fluoxetine addition, no significant change was noted in the UKU side effect scale score. CONCLUSION: As consequence of comparson of plasma amitriptyline and nortriptyline level before and after fluoxetine addition mean amitriptyline, nortriptyline and total plasma level was increased after fluoxetine addition. This suggests that coadministration of amitriptyline and fluoxetine may induce improvement of depressive symptom in depressive patients by way of increased plasma level of amitriptyline.

A Multicenter Study on Effects of Nefazodone(Serzone TM) on Depression, Anxiety, Sleep, Sexual Functions, and Quality of Life in Patients with Depression / 대한정신약물학회지

OBJECTIVE: The aim of this study is to determine effects of nefazodone on depression, anxiety, sleep and sexual function in depressive patients. SUBJECTS AND METHODS: This is an open, non-comparative, multi-center study. Antidepressant and other clinical effects of nefazodone were evaluated in 230 patients of 26 centers, aged 14 years or more, who met DSM-IV criteria to major depressive disorder or dysthymic disorder and didn't have other psychiatric disorders and were physically healthy. The clinical efficacy was assessed at week 1, 2, 4 and 8 using Clinical Global Improvement (CGI), Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory-State Anxiety (STAI-SA). Other clinical effects were assessed with Weekly Sleep Questionnaire, Sexual Functioning Questionnaire and GHQ-QOL-12, a scale for quality of life. Adverse drug reactions were checked with a questionnaire. Post-treatment effects of drug were compared with pre-treatment baseline condition. RESULTS: The response rates by Clincal Grobal Improvement and HAM-D after 8 weeks treatment were 62.4% and 75.2% respectively. Comparing to baseline, nefazodone was proved to have significantly higher antidepressant and antianxiety effects in depressive patients and it improved also sleep, sexual functions and quality of life. Both patients and physicians satisfied with the effects of drug. Adverse drug reactions were a few and not serious, and most of them disappeared as treatment continued. CONCLUSION: These results suggest that not only nefazodone has antidepressant effects and antianxiety effects, but also it improves sleep disturbance, sexual dysfunction and the quality of life in depressive patients. Adverse drug reactions were a few and not serious.

Depression after Traumatic Brain Injury

Traumatic Brain Injury(TBI) of any severity can result in broad and persisting biopsychosocial sequelae. Depression after TBI occur at a greater frequency than in the general population, with estimates approaching 25% to 50% for major depression, and 155 to 30% for dysthmia. Acute onset depressions are related to lesion location and may have their etiology in biological response of the injured brain, whereas delayed onset depressions may be mediated by psychosocial factors, suggesting psychological reactions as a possible mechanism. Anxious depressions are associated with right hemisphere lesions, whereas major depressions alone are associated with left dorsolateral frontal and left basal ganglia lesions. However, there is insufficient information to postulate a specific neuroanatomic model for TBI-related depression.

Defense Mechanisms in the Specialty Choice of Medical Students / 신경정신의학

OBJECTIVES: To determine differences of common personality profiles and coping mechanisms of medical students who prefer specific specialties (medicine and surgery), the authors evaluated the defense mechanisms of the medical students by using Ewha Defense Mechanisms Test. METHODS: The authors compared the defense mechanisms between two groups (medicine selection group and surgery selection group) who are in the senior year of the Soonchunhyang University School of Medicine. RESULTS: There were no significant differences in mean scores of the each defense mechanism and 4 groups of defense mechanisms divided by maturity level between the groups of students who selected medicine and surgery. But, frequency of major defense mechanisms were as follows; For the surgery selection group, the passive-aggression in the Immature defense mechanism and show-off in the Neurotic defense mechanism were significantly higher than in the medicine selection group. Contrarily, in the medicine selection group, humor in the mature defense mechanism as the major defense mechanism was significantly higher than in the surgery selection group. CONCLUSION: After analysis of the differences of frequency of major defense mechanisms between the two groups, there were no significant differences between the two groups in personality. However, the students of the medicine selection group used humor of the mature defense mechanism as a major defense mechanism in higher frequency than the surgery selection group. In situations of complications, anxiety and suffering, the use of the humor defense mechanism gave the students strength to endure these situations. Among these students, there is a high probability that many of them possess strong ego strength. Contrarily, the students of the surgery selection group did not express aggression directly, rather, they expressed these feelings indirectly through passive opposition. There was a high frequency of passive-aggression defense mechanism in dealing with feelings of aggression. Also, in the neurotic defense mechanism, compared to ability, excessive goals were set as was the resulting behavior. Especially, behavior was extremely sensitive to how others would evaluate those actions resulting in using show-off mechanism as a major defense mechanism in higher frequency by the surgery selection group. The results seem to be useful in understanding the student's optimal character for specific specialities that were selected by evaluating the differences of the common characteristics and coping mechanisms of each specialty group.

Sexual Desire Disorder

No abstract available.

Personality Factors and Parental Rearing Attitude Affecting Adolescents Attending School and Incarcerated Delinquent Adolescents' Behavior / 신경정신의학

OBJECTIVES: The purpose of this study was to compare the differences of parental rearing attitude between incarcerated delinqent adolescents and adolescents attending school, in order to identifying the relationships between delinquent behavior and personality factors. METHODS: The subjects were composed of 94 incarcerated delinqent adolescents and 112 adolescents attending school. Subjects were required to complete self-report questionnare including PBI and 16 PF. RESULTS: In incarcerated delinqent adolescents, maternal care(MC) was significantly lower than in adolescents attending school and paternal overprotection(PO) was significantly higher than in adolescents attending school. Of the scores of 16 PF, incarcerated delinqent adolescents showed lower scores in intelligence(B), guilt-proneness(O), liberalism(Q1), self-control(Q3), tension(Q4), anxiety(ANX), superego(SUP) and creativity(CRE) than adolescents attending school. Of the correlation between the scores of PBI and 16PF in incarerated delinqent adolescents, each of superego(G), liberalism(Q1), and supergo(SUP) was negatively correlated with maternal overprotection. Liberalism(Q1) was negatively correlated with paternal overprotection. Stableness(C) was positively correlated with paternal care. Each of gulit-proneness(O), liberalism(Q1), self sufficiency(Q2), tension(Q4), and anxiety(ANX) was negatively correlated with paternal care. In adolescents attending school, groups classified by parental bonding pattern indicated that optimal bonding group(Group l) was correlated with more positive aspects of personality factors, and the affectionless control(Group lV) was correlated with more negative aspects of personality factors. In delinquent adolescents, however, results didn't match the above findings. CONCLUSION: The parent-child bonding patterns of incarcerated delinqent adolescents were related to multiple personality factors. In parental rearing of incarcerated delinqent adolescents, maternal care(MC) was lower and paternal overprotection(PO) was higher than in adolescents attending school. We suggest that personality factors of incarcerated delinqent adolescents are correlated with delinquent behaviors. However, early parent-child bonding patterns do not seem to be correlated with later personality development.

The Relation of Antipsychotic Drug Induced-Acute Dystonia and Serum Iron Level

OBJECT: This study was performed in order to examine the correlation between acute neuroleptic-induced dystonic reactions and serum iron level. METHOD: Serum iron levels were measured in psychiatric inpatients who had developed acute neuroleptic-induced dystonia(N=41) and in control patients with no history of acute dystonic reactions(N=37). Serum iron levels were compared in acute dystonic inpatients before starting treatment with neuroleptics and after acute dystonic reaction. RESULTS: The patients exhibiting acute dystonic reactions had significantly lower serum iron levels than the patients without acute dystonic reactions. CONCLUSION: This result supports an association between low serum iron and the occurrence of neuroleptic-induced acute dystonic reactions.

Risperidone-Induced Mania in Psychoses / 신경정신의학

Risperidone is one of a new class of atypical antipsychotic drug that combines potent dopamine(D2) and serotonin(5-HT2) receptor antagonist properties. In the last few years, there have been several report of risperidone-induced manic symptoms during treatment of schizoaffective disorder or schizophrenia. We report three cases of mania developed in two schizophrenia patients and one amphetamine-induced psychotic disorder which appear to have been precipitated by rispendone. This inducing effect might be attributed to its ability to block postsynaptic 5-HT2 receptors, a property that distinguishes it self from other antipsychotic agents. The blocking of serotonin receptors by risperidone may create a perceived depletion of serotonin similar to that seen in affective disorder and lead to mania. Therefore, we should be cautions in the treatment of psychotic disorder with risperidone.

Efficacy and Safety Profile of Risperidone in Schizophrenia: Open Multicenter Clinical Trial / 신경정신의학

OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. METHOD: This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points: at baseline, and 1,2,4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. RESULTS: 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action: a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. CONCLUSIONS: This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

The Effect of Cyproheptadine Treatment in Neuroleptic Induced Akathisia / 신경정신의학

OBJECTIVE: Neuroleptic Induced Akathisia(NIA) often occurs in neuroleptic treated patients. Cyproheptadine, an antiserotonergic agent, was used to treat neuroleptic induced akathisia. METHOD: In an open trial 21 neuroleptic-treated patients with akathisia were administrated Cyproheptadine(16mg/day) over 4 days. Assessment of akathisia was evaluated using Barnes' rating scale(BAS) for neuroleptic induced akathisia. The degree of depression and psychosis were assessed by brief psychiatric rating scale(BFRS) and Hamilton rating scale for depression(HAM-D). RESULT: Most patients(20 of 21) with neuroleptic induced akathisia(NIA) showed improvement under the treatment of cyproheptadine. There was no aggravation of psychosis or depression during the treatment. Symptoms of akathisia aggravated when cyproheptadine was discontinued. CONCLUSION: Cyproheptadine may be useful in the treatment of neuroleptic induced akathisia(NIA).

A case of pica persisting till age 11 / 신경정신의학

No abstract available.