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522psychdepre08[3]

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522psychdepre08[3]

  1. 1. <ul><li>Psychopharmacology </li></ul><ul><li>George Hsiao </li></ul><ul><li>2008 </li></ul>
  2. 2. Contraindication <ul><li>Benign prostatic hyperplasia (BPH) </li></ul><ul><li>Glaucoma </li></ul><ul><li>Arrhythmias (quinidine-like effect, class Ia) </li></ul><ul><li>Seizure </li></ul>
  3. 6. SSRI TCA Luvox Prozac
  4. 8. SSRIs plus other 5-HT activity (3 rd generation) SSRI + 5-HT 1A Antagonist ( Half-life short )
  5. 9. SSRI + 5-HT 1A Antagonist Premature ejaculation (Dopaxetine, 2005)
  6. 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.
  7. 11. Bupropion <ul><li>PD: some dopaminergic effect (mild psychostimulation) </li></ul><ul><li>dopamine reuptake inhibitor </li></ul><ul><li>Little anticholinergic, cardiac effects and psychosexual inhibition </li></ul><ul><li>First-line treatment of depressive disorders </li></ul>
  8. 12. Symptoms of Borna Disease (bipolar disorder)
  9. 13. <ul><li>Mania Problems </li></ul>
  10. 14. PET Scans of A Bipolar Disorder (D-M-D)
  11. 15. Observations of A 3-week Manic Episode
  12. 16. 300 mg tid
  13. 17. Inositol phosphatases within the neurons
  14. 19. <ul><li>Drug interactions </li></ul><ul><li>a) TCAs-plus-MAOIs==dangerous— hyper sympathetic response. </li></ul><ul><li>b) MAOIs-plus-L-dopa (for anti-Parkinson’s Dz)==dangerous—acute hypertensive reaction. </li></ul><ul><li>c) Induction of hepatic microsomal enzymes (barbiturates). </li></ul><ul><li>d) Selective serotonin reuptake inhibitor (SSRI)-plus-MAOIs==lethal </li></ul><ul><li>“ serotonin syndrome ”—hyperthermia, shivering ( 寒戰 ), myoclonus ( 肌陣縮症 ), agitation ( 精神激昂 ), hypomania, nausea, tremor and coma. </li></ul><ul><li>e) Lithium-plus-thiazide diuretics==dangerous—lithium toxicity . </li></ul>

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