[教学]抑郁症-系统性疾病-魏镜-05-11-06.ppt

抑郁是一种系统性疾病:全面治疗抑郁的情绪和躯体症状 ;提要;抑郁是什么？？？;抑郁障碍的表现;抑郁的症状;抑郁的症状（续）;抑郁的症状（续）;抑郁的躯体症状;抑郁的躯体症状（续）;抑郁的躯体症状（续）;抑郁的躯体症状（续）;抑郁的躯体症状（续）;抑郁症患者常常伴有疼痛性躯体症状;抑郁症: 一个系统性疾病;Kroenke K, et al. Arch Fam Med. 1994;3:774-779.;*;;5-HT=serotonin; NE=norepinephrine; CNS=central nervous system. Adapted from: 1. Fields HL, et al. Annu Rev Neurosci. 1991;14:219-245. 2. Stahl SM. J Clin Psychiatry. 2002;63:382-383.;5-HT功能不足的症状表现;NE功能不足的症状表现;心境 情绪 认知功能;奈发唑酮 米氮平 文拉法辛;1. Edwards JG, Anderson I. Drugs. 1999;57:507-533. SSRIs=citalopram, paroxetine, fluoxetine, fluvoxamine, sertraline. 2. Anderson IM. Depress Anxiety. 1998;7(suppl 1):11-17. SSRIs=citalopram, paroxetine, fluoxetine, fluvoxamine; TCAs=amitriptyline, clomipramine, desipramine, imipramine, maprotiline. 3. Anderson IM, Tomenson BM. J Psychopharmacol. 1994;8:238-249. SSRIs=citalopram, paroxetine, fluoxetine, fluvoxamine, sertraline; TCAs=amitriptyline, clomipramine, desipramine, dothiepin, doxepin, imipramine, maprotiline, nortriptyline. 4. Anderson IM, Tomenson BM. BMJ. 1995;310:1433-1438. SSRIs=citalopram, paroxetine, fluoxetine, fluvoxamine, sertraline; TCAs=amitriptyline, clomipramine, desipramine, dothiepin, doxepin, imipramine, nortriptyline.;1. Anderson IM. Depress Anxiety. 1998;7(suppl 1):11-17. SSRIs=citalopram, paroxetine, fluoxetine, fluvoxamine; TCAs=amitriptyline, clomipramine, desipramine, imipramine, maprotiline. 2. Anderson IM, Tomenson BM. J Psychopharmacol. 1994;8:238-249. SSRIs=citalopram, paroxetine, fluoxetine, fluvoxamine, sertraline; TCAs=amitriptyline, clomipramine, desipramine, dothiepin, doxepin, imipramine, maprotiline, nortriptyline.;Anderson IM. Depress Anxiety. 1998;7(suppl 1):11-17. *TCAs=amitriptyline, clomipramine, desipramine, imipramine, maprotiline. ?SSRIs=citalopram, paroxetine, fluoxetine, fluvoxamine. ?SNRI TCAs=amitriptyline, clomipramine. §NRI TCAs=desipramine, imipramine, maprotiline.;1. Nemeroff CB, et al. Eur Neuropsychopharmacol. 2003;13(suppl 4):S254. Abstract P.1.189. SNRI=venlafa