ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb02927.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Schizophrenia is a devastating illness that can impair all aspects of a patient's life. Although positive psychotic symptoms such as hallucinations and delusions are often emphasized, the negative symptoms of the disease prevent patients from functioning in society and limit their ability to hold a job, attend school, or form friendships. Since schizophrenia is most likely to develop between ages 15 and 25 years, its effects are felt throughout a person's life. Much research has been conducted on the etiology of the disorder, but no single cause has been identified. Most likely, it is the result of a combination of genetic, environmental, and neuropathologic factors. The costs of schizophrenia are high. These patients occupy about 25% of hospital beds. They are paid approximately 10% of Social Security benefit days, as they are often too ill to work. Given the high costs of hospital care, any pharmacologic or psychosocial therapy that can prevent hospitalization will play an important role in the treatment of these patients.

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb02928.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Novel antipsychotic agents differ from conventional ones in several key characteristics, including effectiveness, adverse reactions, and receptor‐binding profile. Most of the newer agents have an affinity for the serotonin 5HT2receptor that is at least f 0 times greater than that for the dopamine D2receptor. This increased affinity for the serotonin receptor may be responsible for another distinguishing characteristic of novel antipsychotic agents—decreased frequency of extrapyramidal side effects. These side effects, which include pseudoparkinsonism, acute dystonias, and akathisia, frequently are the reason for noncompliance with conventional drug therapy. The newer drugs are often effective in patients resistant to treatment with conventional agents. They also appear to reduce the negative symptoms of schizophrenia in many patie

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb02929.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Schizophrenia is an illness with numerous neurobiologic features. It is hypothesized that patients may have a relative deficit of dopamine neurotransmission in the nigrostriatal and mesocortical tracts of the brain, as contrasted with an excess of dopamine neurotransmission in the mesolimbic area. The dopamine deficit may be related to the negative symptoms (blunted affect, anhedonia, asociality, inability to initiate and carry out complex tasks to completion) of schizophrenia, whereas the dopamine excess may be responsible for the positive symptoms (hallucinations, delusions, and thought disorder). Compared with healthy subjects, schizophrenic patients may also have increased levels of serotonin and decreased levels of norepinephrine in the brain. Conventional antipsychotic drugs nonselectively block dopamine D2receptors throughout the central nervous system. This may help reduce positive symptoms, but has little or no effect on negative symptoms. Newer agents have more anatomically selective activity with respect to dopaminergic systems but are more complex with respect to their actions in other neurochemical systems, such as serotonin and norepinephrine, which presumably contributes to their apparent greater therapeutic efficacy.

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb02930.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Various combinations of drugs may be used to treat psychotic disorders, but pharmacodynamic and pharmacokinetic interactions can result in adverse effects. In most cases, interactions are of clinical significance only when drug therapy is initiated or discontinued, or when major changes in dosage are made. A number of patient‐related variables also affect the clinical significance of a drug‐drug interaction. To help predict the occurrence of interactions, and therefore minimize or prevent them, the clinician should be familiar with each agent's pharmacokinetics, the enzymes involved in its metabolism, and the expected pharmacologic effects. With this knowledge, the clinician may consider decreasing the dosage of previous therapy or reducing the dosage of a coadministered drug to prevent or minimize the potential of an adverse interact

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1996.tb02931.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.tb02932.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY