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首页> 外文期刊>The journal of clinical psychiatry >Switching antipsychotic therapy: what to expect and clinical strategies for improving therapeutic outcomes.
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Switching antipsychotic therapy: what to expect and clinical strategies for improving therapeutic outcomes.

机译:转换抗精神病药物疗法:可以期待的结果和改善治疗效果的临床策略。

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摘要

When a patient taking an antipsychotic is not experiencing symptomatic remission, or is experiencing adverse effects (AEs) that are intolerable or damaging to his or her physical health, a change in medication may be the best path to a good outcome. However, many clinicians are reluctant to switch medications in all but the clearest cases of failure. This reluctance is intensified by the occurrence of AEs caused by transitioning patients too rapidly between agents with different receptor-binding profiles. Emergent antipsychotic-switching syndromes include the "withdrawal triad," comprised of cholinergic rebound, supersensitivity psychosis, and emergent withdrawal dyskinesias (and other motor syndromes). More recently, another element has been observed consistent with an activation syndrome. This activation syndrome may occur as a consequence of switching from highly sedative agents or as a consequence of initial prodopaminergic drive. All of these effects can be minimized by careful planning of gradualswitch procedures and judicious use of adjunctive medications.
机译:当服用抗精神病药的患者未出现症状缓解或正在经历无法忍受或损害其身体健康的不良反应(AE)时,更换药物可能是取得良好结果的最佳途径。但是,除了最明显的失败案例外,许多临床医生都不愿更换药物。由于患者在具有不同受体结合特征的药物之间过快转移而引起的AE的出现,加剧了这种不情愿。新兴的抗精神病药物转换综合征包括“戒断三联征”,包括胆碱能反弹,超敏性精神病和紧急戒断运动障碍(以及其他运动综合征)。最近,已经观察到与激活综合征一致的另一种元素。该激活综合征可能是由于从高镇静剂转换而引起的,或者是由于最初的多巴胺能驱动引起的。通过仔细计划逐步转换程序和明智使用辅助药物,可以将所有这些影响降至最低。

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