二胺使用障碍:常见问题和答案
Sandy Robertson1, Emily E Peacock1, Robert Scott1
1Wake Forest University School of Medicine Cabarrus Family Medicine Residency Program, Concord, North Carolina.
American family physician
|September 19, 2023
概括
数以百万计的成年人滥用二,导致诸如镇静和跌倒等不良影响. 停止这些药物的处方需要缓慢的逐渐减少和行为干预,以获得更好的结果.
科学领域:
- 药理学 药理学是指药理学的学科.
- 老年医学 老年医学
- 公共卫生 公共卫生
背景情况:
- bensodiazepine的使用在美国很普遍,超过3000万成年人在过去一年中报告使用.
- 滥用,定义为违反医生的指示使用药物,占所有二二使用量的17.2%.
- 家庭医生扎在平衡患者感知到的益处与已知的风险以及支持二胺疗效的有限证据之间.
研究的目的:
- 审查与二胺使用和滥用相关的风险.
- 讨论在初级保健中管理二二类药物处方的挑战.
- 概述了安全下药的策略.
主要方法:
- 对与二类药物相关的不良影响,危险因素和戒断症状的文献综述.
- 检查戒断期间辅助治疗的证据.
- 分析抑郁症的策略,包括逐渐减少和行为干预.
主要成果:
- 二类药物与显著的中枢神经系统不良影响有关 (镇静,混乱,记忆丧失,抑郁,跌倒,骨折,机动车辆事故).
- 副作用和滥用的危险因素包括物质使用障碍,同时服用中枢神经系统药物和特定疾病.
- 慢性每日使用,特别是在老年人中,增加了跌倒,骨折,住院和死亡的风险.
- 戒断症状是常见的,长时间的,可以通过辅助治疗来减轻.
- 个性化,缓慢的逐渐缩短长时间的时间对于最大限度地减少戒断强度至关重要.
- 行为干预,如认知行为疗法,增强了抑郁症的成功.
结论:
- 二二的使用带来了相当大的风险,特别是在老年人中滥用和不良影响方面.
- 有效的抑郁症需要以患者为中心的方法,逐渐缩小和支持性行为疗法.
- 需要进一步的研究和临床指导方针,以优化二二胺的管理和停止处方的做法.
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