临床药理学 精神病课件.pptVIP

It was reported enhanced prefrontal activity associated with alleviation of negative symptoms and improvement of cognitive functions, following treatment with atypical antipsychotics. Besides increasing prefrontal cortex activity, atypical antipsychotics have also shown to be effective in the regulation of striatal functioning. The current PhMRI findings support the revised DA hypothesis of schizophrenia by confirming hypoactivity of the prefrontal cortex in schizophrenia and, following atypical antipsychotics, improvement of prefrontal and subcortical functions reflecting enhanced DA activity. CATIE and CUtLASS conclusions正确评价第一代和第二代抗精神病药 SGAs are not uniformly or consistently more effective than FGAs; if differences in EPS and anticholinergic use between FGAs and SGAs can be liminated, then differences in effectiveness between them can be substantially diminished or even removed; antipsychotic effectiveness in schizophrenia is still unsatisfactory; completion rate on initially assigned antipsychotic treatment arm at 18 months in CATIE was 26%; different challenges exist in balancing efficacy and tolerability with different agents; the process of switching antipsychotics can be risky; given enormous individual variability in drug handling, responsivity, and susceptibility to and tolerance of different adverse effects, no single approach works for all patients; clozapine is still the gold standard in the treatment of otherwise unresponsive schizophrenia. Schizophrenia Research 100 (2008) 20–38 The Cutting Edge of Schizophrenia Treatment /viewarticle/557148 抑郁症（depression) 抑郁症目前已成为世界第四大疾病 抑郁症在25-35岁和60岁以上的老年人群中发病率最高 女性抑郁症发病率是男性的两倍 自杀，慢性疼痛，有效生命年的影响等问题　　 到2020年，抑郁症将成为女性死亡和残疾的首位疾病，并将成为人类死亡和残疾的第二大疾病，仅次于心脏病 临床表现 （一）痛苦情感 1.抑郁心境：悲伤、痛苦、沮丧 核心症状，但非诊断所必须。无明显原因的，强度、持续时间、范围不同于丧亲、失败等所产生的不愉快情绪。 2.焦虑 最常见的症状之一。不安的预兆，好象可怕的事情将要发生 。伴植物神经系统症状：如口干、心悸、出汗、面部潮红、胃部不适、窒息感、呼吸困难等。 3.激越 指运动不安的严重焦虑。不能安静或不停地走动，严重时完全不能坐下来。 4.易激惹 指当面临挫折时，产生烦恼和愤怒的阈值降低。表现为自我压抑、情绪失控、毁物、暴力行为等。 5.情绪波动 50%的患者