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Biomedical subjects

Ming-Chyi Huang

Publications and source records attributed to Ming-Chyi Huang.

6 recordsLinked to original sources

A double-blind, placebo-controlled study of naltrexone in the treatment of alcohol dependence in Taiwan.

The aim of this study was to investigate the effectiveness of naltrexone in Taiwanese Han males with alcohol dependence. In conjunction with limited supportive psychotherapy, 40 alcoholic patients, who met Diagnostic and Statistical Manual version III revised (DSM-III-R) criteria for alcohol dependence, were assigned to a randomized double-blind, placebo-controlled trial of naltrexone hydrochloride (50 mg/day) for 14 weeks following alcohol detoxification. Among recruited patients, 45% (n = 9/20) of the naltrexone-treated subjects and 35% (n = 7/20) of the placebo-treated subjects dropped out (p = 0.374). The relapse rates between the two groups were not significant (p = 0.671). Subjects taking naltrexone reported less alcohol craving compared with placebo-treated subjects. In support of previous reports, the present results suggest that naltrexone may be safe and effective in craving reduction in alcohol-dependent subjects.

Adult↗

Heavy smoking, reduced olanzapine levels, and treatment effects: a case report.

A 30-year-old schizophrenic male patient, a heavy smoker, was successfully treated with olanzapine 15 mg/d during hospitalization. His cigarette consumption increased rapidly from 12 to 80 cigarettes per day following his discharge. Ten days later, his delusion of persecution, levels of hostility, and aggressive behavior worsened, while the plasma levels of olanzapine concurrently decreased. Based on our observations of this case, we suggest that the reduced levels of plasma olanzapine and exacerbated clinical symptoms are closely related to the increased consumption of cigarettes. A possible explanation would be that heavy smoking induced cytochrome P4501A2, the major enzyme involved in olanzapine metabolism. Therefore, patients who smoke should be closely monitored for their cigarette consumption when the dosage of olanzapine is adjusted.

Adult↗

Dose-dependent alternations in the pharmacokinetics of olanzapine during coadministration of fluvoxamine in patients with schizophrenia.

Olanzapine, an atypical antipsychotic agent, is a substrate of the cytochrome P4501A2 (CYP1A2) enzyme. Administration of a potent CYP1A2 inhibitor (eg, fluvoxamine) may alter the pharmacokinetics of olanzapine. This study investigated the pharmacokinetic interactions between olanzapine and fluvoxamine in patients with schizophrenia. Ten male smokers were administrated a single dose of olanzapine 10 mg at baseline, followed by 2 weeks of fluvoxamine 50 mg/day and another 2 weeks of fluvoxamine 100 mg/day. Olanzapine 10 mg was given at day 10 during each fluvoxamine treatment. After pretreatment with fluvoxamine, the area under the curve, maximal plasma concentration, and half-time of olanzapine were significantly increased by 30% to 55%, 12% to 64%, and 25% to 32%, respectively. Volume of distribution and apparent clearance were significantly reduced by 4% to 26% and 26% t O 38%, respectively, after administration of fluvoxamine. Increases in area under the plasma concentration-time curve from time 0 to infinity appear to be dose dependent. Presumably, altered olanzapine pharmacokinetics are attributed to the inhibition of CYP1A2. Patients treated with the combination of olanzapine and fluvoxamine should be monitored carefully.

Adult↗

Polyunsaturated fatty acid deficit in patients with bipolar mania.

The aim of this study is to test the hypothesis that there is a depletion of polyunsaturated fatty acids of erythrocyte membranes in patients with bipolar disorder and to connect the previous therapeutic and psychoimmunological findings. Fatty acid compositions of erythrocyte membranes in 20 bipolar manic patients and 20 healthy controls were analyzed by thin-layer chromatography and gas chromatography. The major finding was significantly reduced arachidonic acid (20:4n-6) and docosahexaenoic acid (22:6n-3) compositions in bipolar patients as compared to normal controls with P values of 0.000 and 0.002, respectively. There were no differences in total omega-3 and omega-6 polyunsaturated fatty acids. This abnormality may be related to the mechanisms of action of mood stabilizers and the previous findings on the abnormal psychoimmunology of patients with bipolar disorder. Larger sample sizes of medicated patients or drug-free manic, well-controlled designs on the diet and smoking, and fatty acid composition measurements during full remission after the index episode are warranted in future studies.

Adult↗

Shifting from haloperidol to risperidone for behavioral disturbances in dementia: safety, response predictors, and mood effects.

For agitated dementia showing insufficient response to conventional antipsychotics, the feasibility of transition to atypical agents remains unknown. Sixty-two Chinese inpatients with dementia and disruptive behaviors were recruited into an 8-week screening trial of haloperidol. Thirty-five (56%) of them responded insufficiently. They then entered a prospective, 16-week, open-labeled study. Haloperidol was abruptly shifted to risperidone 0.5 mg/day at weeks 1 to 4 and then 1 mg/day at weeks 5 to 12. At weeks 13 to 16, the regimen was shifted back to haloperidol at previous doses, mostly 1 mg/day. Safety, efficacy, cognition, and moods were evaluated at least every 4 weeks. Generalized estimating equation methods were used for determining the effects of the prognostic variables on the outcome values. Risperidone, particularly at 0.5 mg/day, was generally tolerable. The Brief Psychiatric Rating Scale (BPRS) score decreased progressively under risperidone treatment; at week 12, 16 (46%) patients showed response (>or=25% reduction in the BPRS). Patients with vascular dementia were more likely to respond than those with Alzheimer's disease ( p = 0.02). Haloperidol reinstitution resulted in no further improvement, except trend increments in motor symptoms. Risperidone also tended to benefit the performance on the Behavioral Pathology in Alzheimer's Disease Rating Scale. Six (17%) patients improved on moods and self-care with risperidone. These preliminary results suggest that crossover from haloperidol to risperidone is generally safe and effective and may produce favorable moods in agitated dementia patients. Vascular dementia is a predictor of treatment response. In contrast to the dose (1 mg/day) recommended for most white individuals, 0.5 mg/day could be tried at first in Chinese patients. Because of the design's limitations, further controlled studies are warranted.

Activities of Daily Living↗