clonidine用于tourette syndrome.pptVIP

處方內容 處方內容 Tourette Syndrome 定義 “Tourette Syndrome 是一種兒童期病發的慢性神經異常（neuropsychiatric disorder）。 診斷 根據DSM-Ⅳ1994年美國精神學會第四版的診斷和統計手冊，必須符合以下五個條件： （1）在疾病的期間，同時出現多樣性的動作及一種或是多種聲語型tics（儘管不同時發生的也算是）。 （2）Tics一天中發生很多次，（通常是一陣一陣的），幾乎是每天或是超過一年以上間歇性的出現在某ㄧ段時間。 （3）這個疾病會引起明顯的困擾或是社交上、職業上或其他功能上干擾。 （4）18歲以前會出現症狀。 （5）這個疾病並非起因於用了某物質導致直接生理的影響（例如：興奮劑）或是一般醫學的疾病（例如：亨丁頓式舞蹈症或病毒性腦膜炎）。 Causes of tic disorders 治療 Dopamine antagonist---haloperidol,Risperdal Clonidine Clonazepam Pergolide Mesylate clonazepam Dose range for clonazepam is 0.25mg twice daily to 1 mg three times daily. Pergolide Mesylate Gilles de la Tourettes syndrome FDA Approval: Adult, no; Pediatric, no Efficacy: Pediatric, Evidence favors efficacy Decreased tic severity in a small cross-over study The starting dose of pergolide 25micrograms/day was increased by 25-mcg increments every 3 days to 150 mcg/day, administered three times daily. maximum dosage of 300 mcg daily if clinically necessary. 討論 1.第一個症狀通常是臉部抽筋，例如：眨眼睛。 2 .妥瑞氏症在所有人種皆可見。 3.男性妥瑞氏症的發生率比女性高三到四倍。 4.睡眠時發生抽筋的頻率和強度逐漸減少。 5.妥瑞氏症不影響患者的智商。 6.大部分的妥瑞氏症患者都能擁有工作以及豐富的人生。 * * 門診處方用藥討論 報告日期：95.10.19 報告者：黃聖秀藥師 clonidine for the treatment of Tourette Syndrome 處方內容 處方內容 FIGURE 1. The clinical course of Tourettes syndrome. Onset typically occurs before seven years of age and the disorder is usually recognized two to three years after onset. In most children, the severity peaks at nine to 11 years of age. About 5 to 10 percent of patients have an intensifying course with little or no improvement. In about 85 percent of patients, symptoms diminish during and after adolescence. ?????????????????????????????????????????????????????????????????????????????????????????????????????????? Clinical Course of Tourettes Syndrome FIGURE 1. The clinical course of Tourettes syndrome. Onset typically occurs before seven years of age and the disorder is usually recognized two to three years after onset. In most children, the severity peaks at nine to 11 years of age. About 5 to 10 perc