ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb03667.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The hypothesis that altered dopamine function is a major factor in the etiology of schizophrenia has persisted for some time, and changes in other neurochemical systems are strongly implicated as well. These findings are supported by the recent development of new, effective antipsychotic agents, such as clozapine and risperidone, whose actions are attributed to their combined serotonin and dopamine antagonism. In addition to their clinical efficacy, these agents are associated with substantially fewer extrapyramidal adverse effects. Continued research to identify the neurochemical alterations of psychotic diseases will undoubtedly have a favorable impact on the development of improved therapeutic regimens.

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb03668.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Benzodiazepines have a checkered history in the United States; public and professional attitudes about them have ranged from their being wonder drugs in the 1970s to being virtually purged from many formularies as addictive and dangerous in the 1980s. The attitude today is that they are useful for specific indications. In the last 20 years they have been investigated as adjunctive agents to conventional antipsychotic drugs in the treatment of schizophrenia. Benzodiazepines may be effective in schizophrenia because stress is one mediator of relapse in these patients. In addition, inhibition of dopamine neurotransmission through γ‐aminobutyric acid‐enhancing activity may provide a direct antipsychotic effect. As monotherapy or adjuncts to antipsychotic agents, benzodiazepines produced antipsychotic effects in schizophrenia in approximately 50% of controlled trials. Although there is no particular benzodiazepine of choice, low‐potency compounds with long elimination half‐lives are recommended. Adverse effects of concern include sedation and cognitive impairment, behavioral disinhibition, exacerbation of psychotic symptoms, and the potential for dependence, withdrawal, and abuse. The recent arrival of atypical antipsychotic drugs has significantly slowed research and interest in benzodiazepines in schizophrenia beyond their initial beneficial sedative effects for acute psychotic

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb03669.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Agitation is a nonspecific constellation of symptoms seen in a variety of psychiatric disorders, ranging from psychotic exacerbations in patients with schizophrenia to behavioral disturbances associated with organic factors. Its treatment must be individualized and based on the etiology of the psychomotor disturbance. Certain categories of drugs are broadly effective. Sedation and control of disruptive and dangerous behavior are the initial goals in stabilizing acutely agitated patients. Sedation is necessary during the lag period before antipsychotic and mood‐stabilizing drugs take effect. Barbiturates and chlorpromazine, initially given to control agitated behavior, are largely supplanted by higher‐potency antipsychotics, benzodiazepines, and, recently, a combination of these two agents. Agitation is generally controlled within hours to days, whereas remission of affective or psychotic symptoms often requires weeks to months. Once remission is obtained, sedation is no longer desired and may be a barrier to optimal patient function and compliance. Thus, for long‐term treatment, strategies are used to minimize sedation, such as reducing dosages, changing administration to bedtime, or adding antidepressants or stimulants where approp

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb03670.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The atypical antipsychotic agents clozapine and risperidone bring new insight into the care and treatment of patients with schizophrenia. Since their introduction, several names (e.g., novel, atypical, serotonergic‐dopaminergic antagonist) have been used to describe the nature of these compounds. The agents are unique in a number of ways compared with conventional neuroleptics. In particular, they have the distinction of having achieved separation between the effective dosage and the dosage that causes extrapyramidal symptoms, which has significant implications for patient care. On the whole, the advent of atypical agents is changing treatment protocols for patients with schizophreni

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb03671.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb03672.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY