厌恶性代理人:想一想,两次. 一个关于二硫诱导的躁狂病例报告
María Fernanda González-Romero1, José María Martínez-Ávila1, Elizabeth Moloney2
1Department of Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Bipolar disorders
|November 28, 2023
概括
用于治疗酒精使用障碍的迪苏尔菲拉姆可以在同时出现精神兴奋剂使用障碍的患者中引发躁狂. 症状在停止服用药物后消失,强调需要对患者进行仔细监测.
科学领域:
- 精神病学是一个精神病学.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 迪苏尔菲拉姆是治疗酒精使用障碍 (AUD) 的关键药物.
- 同时发生的精神兴奋剂使用障碍 (PUD) 在AUD患者中很常见.
- 迪苏尔菲拉姆可能诱发躁狂,特别是在PUD患者中,需要进行调查.
研究的目的:
- 在患有同时出现酒精使用障碍 (AUD) 和精神兴奋剂使用障碍 (PUD) 的患者中报告迪苏尔菲拉姆诱导的躁狂病例.
- 探索潜在的神经生物学机制,如多巴胺失调,将二硫代谢与躁狂症状联系起来.
- 强调对处方disulfiram的患者进行警监测的重要性,特别是那些有精神病史的患者.
主要方法:
- 病例报告详细介绍了患有躁狂症状的患者的临床表现,治疗和结果.
- 审查患者的病史,包括AUD和PUD,以及药物治疗方案.
- 在停止使用迪苏尔菲拉姆后观察症状的消失.
主要成果:
- 患者在开始用于AUD治疗的dissulfiram治疗10天后出现了急性躁狂症状.
- 这位患者以前没有精神病或躁狂史.
- 在住院期间停止服用迪苏尔菲拉姆后,躁狂症状迅速消失.
结论:
- 迪苏尔菲拉姆可以导致躁狂发作,即使在没有躁狂或精神病史的人身上也是如此.
- 在迪苏尔菲拉姆治疗期间密切监测至关重要,特别是对于有精神疾病史或同时使用物质的患者.
- 改变多巴胺水平在迪苏尔菲拉姆代谢中的潜在作用可能有助于观察到的躁狂表现.
相关概念视频
Mania and Antimanic Drugs: Overview
197
Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as...
197
Antidepressant Drugs: MAOIs and Other Agents
248
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
248
Sedatives and Hypnotics Drugs: Miscellaneous Agents
179
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
179
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
303
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
303
CNS Depressants: Alcohol and Nicotine
215
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
215
Anticholinesterase Agents: Poisoning and Treatment
877
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
877


