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522psychdepre08[3]

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Transcript

  • 1.
    • Psychopharmacology
    • George Hsiao
    • 2008
  • 2. Contraindication
    • Benign prostatic hyperplasia (BPH)
    • Glaucoma
    • Arrhythmias (quinidine-like effect, class Ia)
    • Seizure
  • 3.  
  • 4.  
  • 5.  
  • 6. SSRI TCA Luvox Prozac
  • 7.  
  • 8. SSRIs plus other 5-HT activity (3 rd generation) SSRI + 5-HT 1A Antagonist ( Half-life short )
  • 9. SSRI + 5-HT 1A Antagonist Premature ejaculation (Dopaxetine, 2005)
  • 10. SSRI Discontinuation Syndrome The abrupt discontinuation of an SSRI (especially one with a shorter half-life such as paroxetine, sertraline, or fluvoxamine) has been associated with a syndrome that way include: somatic and psychological symptoms. (i) Somatic symptoms : dysequilibrium (dizziness, vertigo and ataxia), tremor, fatigue and migraine-like auras. (ii) Psychological symptoms : anxiety, agitation, lowered mood, confusion, memory problems, and vivid dreams.
  • 11. Bupropion
    • PD: some dopaminergic effect (mild psychostimulation)
    • dopamine reuptake inhibitor
    • Little anticholinergic, cardiac effects and psychosexual inhibition
    • First-line treatment of depressive disorders
  • 12. Symptoms of Borna Disease (bipolar disorder)
  • 13.
    • Mania Problems
  • 14. PET Scans of A Bipolar Disorder (D-M-D)
  • 15. Observations of A 3-week Manic Episode
  • 16. 300 mg tid
  • 17. Inositol phosphatases within the neurons
  • 18.  
  • 19.
    • Drug interactions
    • a) TCAs-plus-MAOIs==dangerous— hyper sympathetic response.
    • b) MAOIs-plus-L-dopa (for anti-Parkinson’s Dz)==dangerous—acute hypertensive reaction.
    • c) Induction of hepatic microsomal enzymes (barbiturates).
    • d) Selective serotonin reuptake inhibitor (SSRI)-plus-MAOIs==lethal
    • “ serotonin syndrome ”—hyperthermia, shivering ( 寒戰 ), myoclonus ( 肌陣縮症 ), agitation ( 精神激昂 ), hypomania, nausea, tremor and coma.
    • e) Lithium-plus-thiazide diuretics==dangerous—lithium toxicity .