抗精神病药抗抑郁药抗躁狂药.ppt

继发于身体疾病的抑郁障碍 内科住院者 16.84% 外科住院者 16.46% 癌症住院者 42% 中风后 47% 心肌梗塞后 45% 帕金森症 39% 糖尿病住院者 40.43% 终末期肾功能衰竭透析 74.47% 血液病住院者 35% Symptoms of Depression You no longer enjoy things like you once did You can’t fall asleep or you wake up and can’t go back to sleep You feel tired during the day You no longer enjoy food You find yourself eating more or less than usual Symptoms of Depression You have gained or lost weight You have a hard time concentrating You find it hard to sit still You cannot make even simple decisions You feel guilty or bad about yourself Symptoms of Depression You feel people would be better off without you You think about suicide or about ways to hurt yourself If any of these symptom apply or if you have been feeling sad or hopeless for more than a few weeks, seek help from your doctor 心境低落 兴趣减退或丧失，无快感 精力减退，持续疲乏 精神运动性迟滞或激动 自我评价下降，自责，内疚，自罪 联想困难，思考能力下降 自杀意念或行动 失眠，早醒或睡眠过多 食欲不振或多食，体重减轻 性欲抑制 症状 睡眠障碍 98% 疲乏 83% 咽喉和胸部紧缩感 75% 食欲障碍 71% 便秘 67% 体重减轻 63% 头疼 42% 身疼 42% 胃肠症状 36% 抑郁症病人的躯体症状 抑郁症 231例 误认为躯体疾病74例（32.0%） 分类: 三环类（tricyclic antidepressants，TCAs） 单胺氧化酶抑制剂（monoamine oxidase inhibitors, MAOIs） 选择性5-HT重摄取抑制剂（selective serotonin reuptake inhibitors, SSRIs） 抗抑郁药 Antidepressants 去甲肾上腺素和特异性5-羟色胺抗抑郁药(noradrenergic and specific serotonergic antidepressant, NaSSA) 5-HE/NA再摄取抑制剂(serotonin noradrenaline re-uptake inhibitor, SNRI) 非典型（或杂环类）抗抑郁药（typical/heterocyclic antidepressants） 1950 1960 1970 1980 1990 2000 non-selective tricyclic AD TCA SSRI selective serotonin re-uptake inhibitor SNRI serotonin noradrenaline re-uptake inhibitor mono-amine oxidase inhibitor MAOI Offering new therapeutic approach