课件：忧郁症的诊断与治疗振兴医院.ppt

NaSSA Mirtazapine (Remeron) Alpha 2 antagonism, therefore increases 5HT and NE Only 5HT1A receptors are stimulated because 5HT2A, 5HT2C and 5HT3 receptors are blocked. Sedation and weight gain due to H1 receptor blockage NDRI Bupropion Norepinepherine and Dopamine reuptake inhibitors NDRI Sustained release formulation (bupropion SR, Wellbutrin) reduces risk of seizure Used on retarded, low energy depression Decreasing the craving associated with smoking cessation No sexual dysfunction Side effects Risk of seizure, insomnia, agitation Criteria for referral to psychiatrists Severe/recurrent depression and /or high suicidal risk No/partial response to conventional tx for depression Type of treatment with documented efficacy Adequate dose and duration of antidepressant Diagnostic complexity Comorbidity (physical/psychiatric) Differential diagnosis Patient’s preference for psychiatric treatment Thank You for Your Attention THANK YOU SUCCESS * * 可编辑 * AADDBDCCC * 憂鬱症常與其他身體疾病共並 有越來越多的醫學實證認為，情緒疾患及許多身體疾病之間的生物機轉是相關連的， 且情緒疾患將影響身體疾病的預後 * Slide 3 另一種表現方式 * * Although specific pathophysiological mechanisms underlying such associations are poorly understood, there is a substantial body of literature documenting increased prevalence of depression in several chronic medical illnesses, including various forms of vascular disease (cardiovascular, cerebrovascular腦血管, or peripheral Vascular週邊血管), diabetes mellitus, and arthritis. Specifically, patients with cardiovascular disease appear to have approximately three times the risk for depression, those with diabetes mellitus have two to three times the risk, and those with arthritis seem to have 40% to 60% more risk for depression. 心血管、腦血管、週邊血管 糖尿病 關節炎 * * * patients with moderate to severe depression at baseline had higher rates(HR:2.2-2.4) of death than did those with no depression. Despite advances in surgical and medical management of patients after CABG, depression is an important independent predictor of death afte