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潘集阳教授抑郁症讲座课件 - 抑郁与心境障碍_精品
* * * * * * * * * * * * * * * * * Psychopharmacological treatment of individuals with bpd has two goals: Reduction of current symptoms Prevention of relapse Medications are prescribed to treat acute episodes as well as for ongoing maintenance. Mood stabilizers are the first line of treatment for any phase of bpd. A mood stabilizer is a drug that will not “destabilize” the disorder, or cause a switch to the opposite pole (e.g., from depression to mania). Switching is the most relevant problem for many of the treatments of bp depression. Bipolar depression is treated somewhat differently for this reason. This points to the importance of a correct diagnosis. The two states of bpd are treated with different medications. Real briefly, these medications may be prescribed when an individual is in a particular cycle of the disorder… Bipolar depression=Again, first line is a mood stabilizer, Lamictal has been shown to be efficacious without promoting switching. Anti-Obsessional meds, such as Paxil have also demonstrated efficacy with the risk of switching. Antidepressants are a more gray area. Atypical antidepressant Wellbutrin is particularly effective. The more classic antidepressants: such as Tricyclic’s (Tri’s) or MAO’s are not effective with bp depression (MAO’s=Moller, et al., 2001). Tri’s have been shown to more than triple the possibility of triggering a manic episode (as cited in Chou, 2004). SSRI’s reportedly do not cause a switch into mania, but are a second choice after Wellbutrin. Atypical Antipsychotics have also been shown to effectively treat bp depression. Many of the same approaches are used with manic episodes, of course, first line is a mood stabilizers: the infamous lithium, which still demonstrates to be the most effective medication in the treatment of mania. Also depakote, depacon, and tegretol have been used successfully. Atypical antipsychotics are effective in the treatment of mania, zyprexa, seroquel, risperdal, geodon and abi
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