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逐步减少抗精神病药物:从案例研究和神经生物学原则中吸取实践教训
Mark A Horowitz1,2, Joanna Moncrieff1,2
1Division of Psychiatry, University College London, Maple House, Fitzrovia, London.
缓慢地在几个月内处方抗精神病药物,可以降低复发率并最大限度地减少戒断症状. 对于长期接受抗精神病治疗的患者来说,逐渐减少剂量是谨慎的.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 越来越多地关注精神病学中的抑郁症抗精神病药物的处方.
- 承认并非所有患有精神病的患者都需要终身抗精神病治疗.
研究的目的:
- 提供关于抗精神病药物的抑郁处方的指导.
- 总结关于抗精神病抑郁症的经验和理论论文.
- 检查与降低抗精神病剂量相关的案例研究.
主要方法:
- 关于抗精神病抑郁症的经验和理论文献的综述.
- 对例证研究的分析,说明抗精神病药物剂量减少.
- 检查最近关于逐渐减少率和复发的研究结果.
主要成果:
- 较慢的抗精神病药物逐渐减少 (数月) 与较快的逐渐减少 (数周) 相比,与较低的复发率有关.
- 降低抗精神病剂量可能会加速或加剧精神病症状,而较慢的降低可能会最大限度地降低这种影响.
- 逐渐降低剂量可以减轻家庭静止平衡的破坏,并降低精神病症状恶化的风险.
结论:
- 缓慢的抗精神病药物逐渐减少允许适应,可能降低复发风险.
- 减量期间精神病症状恶化可能表明需要更逐渐的逐渐减量,不一定需要更高的长期剂量.
- 在临床实践中,建议谨慎逐步减少抗精神病药物,特别是在长期使用后.
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