【正文】
Recognize and manage psychiatric comorbidities in patients with epilepsy. Panminerva Med. 2011 Dec。53(4):24151. PRESCRIBING AND SHARED CARE GUIDANCE FOR THE TREATMENT OF DEPRESSION IN ADULTS OVER 18 YEARS OF AGE. NHS. March, 2010.,第三十五頁(yè),共四十四頁(yè)。,西酞普蘭治療(zh236。li225。o)帕金森氏病伴發(fā)抑郁的研究,Devos D, et al. Comparison of desipramine and citalopram treatments for depression in Parkinson39。s disease: a doubleblind, randomized, placebocontrolled study. Mov Disord. 2008 Apr 30。23(6):8507. Menza M, et al. Citalopram treatment of depression in Parkinson39。s disease: the impact on anxiety, disability, and cognition. J Neuropsychiatry Clin Neurosci. 2004 Summer。16(3):3159. Rampello L, et al. The SSRI, citalopram, improves bradykinesia in patients with Parkinson39。s disease treated with Ldopa. Clin Neuropharmacol. 2002 JanFeb。25(1):214.,第三十六頁(yè),共四十四頁(yè)。,英國(guó)國(guó)民保健體系(NHS) 抗抑郁藥治療癡呆患者(hu224。nzhě)的精神行為癥狀,Guidelines for Managing Behaviour Problems in Patients with Dementia (BPSD). JAPC. 2011,第三十七頁(yè),共四十四頁(yè)。,小 結(jié),第三十八頁(yè),共四十四頁(yè)。,英國(guó)國(guó)家衛(wèi)生與臨床優(yōu)化研究所(NICE) 不同抗抑郁藥的臨床風(fēng)險(xiǎn)(fēngxiǎn)有差異,SSRI類(lèi)藥的風(fēng)險(xiǎn)/獲益比最佳,是一線(xiàn)抗抑郁藥。 某些抗抑郁藥有特定的警示: 高劑量文拉法辛可能加重心律不齊,而且需監(jiān)測(cè)血壓。 文拉法辛和度洛西汀可能影響高血壓。 TCAs可能引起體位性低血壓和心律不齊。 老年患者服用米安舍林需監(jiān)測(cè)血象。 通常只有(zhǐyǒu)精神專(zhuān)科醫(yī)生才能處方不可逆MAOIs,如苯乙肼。 不要處方度硫平。,THE NICE GUIDELINE ON THE TREATMENT AND MANAGEMENT OF DEPRESSION IN ADULTS. UPDATED EDITION. National Institute for Health amp。 Clinical Excellence. 2010.,第三十九頁(yè),共四十四頁(yè)。,新型抗抑郁藥的綜合獲益:薈萃分析(fēnxī)指標(biāo),Gerald Gartlehner, et al. Comparative Benefits and Harms of SecondGeneration Antidepressants: Background Paper for the American College of Physicians. Ann Intern Med. 2008。149:734750.,第四十頁(yè),共四十四頁(yè)。,薈萃(hu236。cu236。)分析顯示: 西酞普蘭的綜合療效獲益趨勢(shì)優(yōu)于其他新型抗抑郁藥,Gerald Gartlehner, et al. Comparative Benefits and Harms of SecondGeneration Antidepressants: Background Paper for the American College of Physicians. Ann Intern Med. 2008。149:734750.,SSRI更優(yōu)? ?SSNRI/SNRI更優(yōu) 相對(duì)(xiāngdu236。)獲益比(95%CI),西酞普蘭更優(yōu),西酞普蘭vs度洛西汀 0.76(0.391.47) 西酞普蘭vs文拉法辛 0.79(0.411.52) 西酞普蘭vs米氮平 0.78(0.401.53),第四十一頁(yè),共四十四頁(yè)。,美國(guó)航空管理局(FAA) 西酞普蘭是飛行員獲準(zhǔn)(hu242。zhǔn)使用的抗抑郁藥,美國(guó)航空管理局(FAA)許可空乘人員(r233。nyu225。n)服用西酞普蘭治療輕中度抑郁: 輕中度、單發(fā)或復(fù)發(fā)的重性抑郁障礙 心境惡劣 有抑郁情緒的適應(yīng)障礙,Special Issuance of Airman Medical Certificates to Applicants Being Treated With Certain Antidepressant Medications. Docket No. FAA–2009–0773.,第四十二頁(yè),共四十四頁(yè)。,控制風(fēng)險(xiǎn)(fēngxiǎn),才能使命必達(dá),第四十三頁(yè),共四十四頁(yè)。,內(nèi)容(n232。ir243。ng)總結(jié),綜合醫(yī)院抗抑郁藥物治療的 風(fēng)險(xiǎn)管理。Baldwin, Montgomery,。隨機(jī)、22析因研究。西酞普蘭vs布洛平 0.87(0.451.68)。西酞普蘭vs萘法唑酮 0.83(0.411.69)。西酞普蘭vs度洛西汀 0.76(0.391.47)。西酞普蘭vs文拉法辛 0.79(0.411.52)。西酞普蘭vs米氮平 0.78(0.401.53)??刂骑L(fēng)險(xiǎn),才能(c225。in233。ng)使命必達(dá),第四十四頁(yè),共四十四