Use of Arotinolol Pharmacotherapy to Treat Drug-induced Tremor: A Report of Three Cases.

OBJECTIVE: The aim of the present study is to demonstrate the effect of arotinolol on drug-induced tremor in psychiatric patients. METHODS: This is a case study of three psychiatric patients with the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnosis of major depressive disorder who were treated in inpatient or outpatient psychiatric settings with antidepressant or antipsychotics. Patients developed tremor. Arotinolol was started to treat the tremor. RESULTS: Drug-induced tremor almost resolved completely. No adverse effects were observed. CONCLUSION: We have presented a case series of drug-induced tremors that responded well to treatment with arotinolol, which appears to be a safe and well-tolerated drug in the dose ranges used. The possible utility of arotinolol to treat drug-induced tremor deserves attention and further investigation.

Hyponatremia associated with selective serotonin reuptake inhibitors, mirtazapine, and venlafaxine in Korean patients with major depressive disorder.

OBJECTIVE: Several reports of hyponatremia associated with the use of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) have been published. This study compared the incidence of hyponatremia associated with SSRIs to that associated with mirtazapine and with venlafaxine in patients with major depressive disorder (MDD). MATERIAL AND METHODS: This retrospective study examined MDD in patients treated with an antidepressant over at least 4 weeks. Using medical records of 93 patients treated with an SSRI (paroxetine, sertraline, escitalopram, and fluoxetine), 76 patients treated with mirtazapine, and 71 patients treated with venlafaxine, we analyzed demographic variables and changes in serum sodium levels (at baseline and Week 4). RESULTS: Eight SSRIs group patients (8.6%) and three venlafaxine group patients (4.2%) exhibited mild hyponatremia during the study period. The SSRIs group's serum sodium level decreased only slightly, but significantly during treatment; however serum sodium levels in the mirtazapine and venlafaxine groups did not change significantly. The risk of developing hyponatremia while on an SSRI was greater in elderly subjects (60 years and older). CONCLUSION: These results indicate that, among patients with MDD, SSRIs treatment may be associated with decreased serum sodium levels, and the elderly patients are at greater risk for hyponatremia. Further prospective studies would help clarify the relative risks of hyponatremia among various antidepressants.

An open pilot trial of olanzapine for delirium in the Korean population.

This study was performed to assess the efficacy and safety of olanzapine for the treatment of delirium in a Korean population. An open trial of olanzapine was conducted in Korean patients with delirium caused by multiple medicosurgical conditions. All subjects were evaluated by Delirium Rating Scale (DRS), which is known to be one of the most sensitive scales for delirium. In addition, other data for profiles of side-effects were collected and analyzed. Twenty patients were treated by olanzapine with doses of 5.9 +/- 1.5 mg/day. The initial dose was 4.6 +/- 0.9 mg/day and maximal dose of olanzapine was 8.8 +/- 2.2 mg/day. The average duration of treatment was 6.6 +/- 1.7 days and the day of maximal response was 3.8 +/- 1.7 treated days. The scores of DRS were significantly improved from 20.0 +/- 3.6 at the time of pretreatment to 9.3 +/- 4.6 at the post-treatment. All subjects showed no definite serious side-effects including anticholinergic and extrapyramidal symptoms. Olanzapine treatment for patients with delirium was effective and safe. This newer drug may be a useful alternative agent to classical antipsychotics in the treatment of delirium.

Polymorphism of CTLA-4 gene for major depression in the Korean population.

This study was carried out to verify the relationship between major depression and cytotoxic T lymphocyte antigen-4 (CTLA-4), which is related to immunological function such as T-cell regulation. Among the Korean patients diagnosed with major depression according to DSM-IV, 77 patients without neurological illness, hormonal disorder, or comorbid mental illness were selected. The stored data on 149 normal Koreans from the Catholic Hemopoietic Stem Cell Bank of Korea, were used as a control group. The data of the Korean control group were compared with those of the studies of different ethnic groups. DNA was extracted from whole blood using proteinase K and the exon 1 region of CTLA-4 gene was amplified by polymerase chain reaction. Gene typing was performed using single strand conformation polymorphism. The results were assessed. There were significant differences in frequencies of CTLA-4 allele (chi2 = 56.472, d.f. = 1, P = 0.001) and genotype (chi2 = 46.132, d.f. = 2, P = 0.001) between the Korean population and the Caucasian population. However, we could not find any differences between the Korean and the Japanese population. There were no significant differences in genotype frequencies of CTLA-4*G/G, CTLA-4*G/A, and CTLA-4*A/A between the patients with major depression and the control group in the Korean population (48.1% vs. 46.3%, 41.6% vs 39.6%, 10.3% vs. 14.1%, respectively). There were no significant differences in allelic frequencies of CTLA-4*G and CTLA-4*A between the patients with major depression and the control group in the Korean population (68.8% vs. 66.1%, 31.2% vs. 33.9%, respectively). Although the present study produced negative results for the association of exon 1 polymorphism of CTLA-4 gene with major depression in the Korean population, further systematic research, including diverse clinical variables, would be necessary.