Journal List > J Korean Med Assoc > v.54(10) > 1042356

Woo and Bahk: Recent advances in the pharmacotherapy of psychiatric disorders

Abstract

Psychopharmacology has developed over approximately the past five decades. The remarkable proliferation of information in this area has made it difficult for clinicians to understand the characteristics of various psychotropic agents. Atypical antipsychotics including amisulpride, asenapine, aripiprazole, blonanserin, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone, and zotepine cause fewer extrapyramidal problems and have many clinical applications, but they can cause metabolic disturbances. Mood stabilizers and lamotrigine are widely used for bipolar disorder. Other novel anticonvulsants such as topiramate, oxcarbazepine, gabapentin, tiagabine, pregabalin, vigabatrin, levetiracetam, and riulzole have also been tested with diverging or inconclusive results. Antidepressants are commonly used in the clinical treatment of depression and anxiety disorder. However, the mechanism of action of medications used in the treatment of psychiatric disorders remains unclear. Understanding the mechanisms of action and clarifying the diagnosis may enhance the treatment outcome in psychiatry. In this review, we analyzed clinical pharmacology data for each drug within a class and discussed clinical strategies for administering currently available antipsychotics, mood stabilizer/anticonvulsants, and antidepressants widely used for various psychiatric indications.

References

1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006. 3:e442.
crossref
2. The global burden of disease: 2004 update [Internet]. World Health Organization. 2008. cited 2011 Sep 9. Geneva: World Health Organization;Available from: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf.
3. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005. 62:593–602.
crossref
4. Korean Neuropsychiatric Association. Textbook of neuropsychiatry. 2005. Seoul: Jungangmunhwa.
5. Ahn YM, Kim DJ, Kwon JS, Bahk WM, Lee HS, Kim YS. Korean medication algorithm projects for major psychiatric disorders (I): the benefit and risk of algorithm and the general considerations of developing medication algorithm. Korean J Psychopharmacol. 2002. 13:18–29.
6. Schwartz TL, Stahl SM. Treatment strategies for dosing the second generation antipsychotics. CNS Neurosci Ther. 2011. 17:110–117.
crossref
7. Mathews M, Muzina DJ. Atypical antipsychotics: new drugs, new challenges. Cleve Clin J Med. 2007. 74:597–606.
crossref
8. Lee HS. Clinical neuropsychopharmacology. 2009. Seoul: ML Communication.
9. Seo HJ, Woo YS, Bahk WM. Atypical antipsychotics in bipolar depression: neurobiological mechanisms and application to treatment. Korean J Psychopharmacol. 2007. 18:384–392.
10. Gao K, Sheehan DV, Calabrese JR. Atypical antipsychotics in primary generalized anxiety disorder or comorbid with mood disorders. Expert Rev Neurother. 2009. 9:1147–1158.
crossref
11. Woo YS, Bahk WM, Jo SH, Yoon BH, Lee JG, Kim W, Jeong JH, Seo JS, Min KJ, Jon DI. Effect of initial ziprasidone dose on treatment outcome of Korean patients with acute manic or mixed episodes. Psychiatry Investig. 2011. 08. 02. [Epub].
crossref
12. Deeks ED, Keating GM. Blonanserin: a review of its use in the management of schizophrenia. CNS Drugs. 2010. 24:65–84.
13. Yang J, Bahk WM, Cho HS, Jeon YW, Jon DI, Jung HY, Kim CH, Kim HC, Kim YK, Kim YH, Kwon JS, Lee SY, Lee SH, Yi JS, Yoon BH, Kim SH. Efficacy and tolerability of Blonanserin in the patients with schizophrenia: a randomized, double-blind, risperidone-compared trial. Clin Neuropharmacol. 2010. 33:169–175.
crossref
14. Green B. Zotepine: a clinical review. Expert Opin Drug Metab Toxicol. 2009. 5:181–186.
crossref
15. Citrome L. Iloperidone, asenapine, and lurasidone: a brief overview of 3 new second-generation antipsychotics. Postgrad Med. 2011. 123:153–162.
crossref
16. Grunze HC. Anticonvulsants in bipolar disorder. J Ment Health. 2010. 19:127–141.
crossref
17. Bahk WM, Jon DI. Bipolar disorder. 2009. Seoul: Sigma press.
18. Goodwin FK. Rationale for long-term treatment of bipolar disorder and evidence for long-term lithium treatment. J Clin Psychiatry. 2002. 63:Suppl 10. 5–12.
19. Altamura AC, Lietti L, Dobrea C, Benatti B, Arici C, Dell'Osso B. Mood stabilizers for patients with bipolar disorder: the state of the art. Expert Rev Neurother. 2011. 11:85–99.
crossref
20. Jones RM, Arlidge J, Gillham R, Reagu S, van den Bree M, Taylor PJ. Efficacy of mood stabilisers in the treatment of impulsive or repetitive aggression: systematic review and metaanalysis. Br J Psychiatry. 2011. 198:93–98.
crossref
21. Denicoff KD, Smith-Jackson EE, Disney ER, Ali SO, Leverich GS, Post RM. Comparative prophylactic efficacy of lithium, carbamazepine, and the combination in bipolar disorder. J Clin Psychiatry. 1997. 58:470–478.
crossref
22. Woo YS, Bahk WM, Jon DI, Joo YH, Kim W, Seo JS, Ahn YM, Chung SK, Won SH, Shin YC, Yoon BH, Jung SH, Seok JH, Lee YS, Kim Y, Min KJ. Rash in adult patients receiving lamotrigine to treat bipolar I disorder in Korea: a multicenter, prospective, naturalistic, open-label trial. Prog Neuropsychopharmacol Biol Psychiatry. 2009. 33:1147–1152.
crossref
23. Ravindran LN, Stein MB. The pharmacologic treatment of anxiety disorders: a review of progress. J Clin Psychiatry. 2010. 71:839–854.
24. Johnson BA. Medication treatment of different types of alcoholism. Am J Psychiatry. 2010. 167:630–639.
crossref
25. Soyka M, Rosner S. Emerging drugs to treat alcoholism. Expert Opin Emerg Drugs. 2010. 15:695–711.
crossref
26. Mann JJ. The medical management of depression. N Engl J Med. 2005. 353:1819–1834.
crossref
27. Woo YS, Bahk WM. Is tianeptine in a class of its own? Pharmacological profiles and clinical use of tianeptine. Korean J Psychopharmacol. 2010. 21:173–182.
28. Demyttenaere K. Agomelatine: a narrative review. Eur Neuropsychopharmacol. 2011. 08. 10. [Epub]. DOI: 10.1016/j.euroneuro.2011.07.004.
crossref
29. Lindsey WT. Vilazodone for the treatment of depression. Ann Pharmacother. 2011. 45:946–953.
crossref
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