兒童青少年精神分裂癥的藥物治療ppt課件

1、Page 2中華醫(yī)學(xué)會(huì)精神病學(xué)分會(huì). 精神分裂癥防治指南第二版.2021.140.精神病學(xué)第五版American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2021 Sep;529:976-90.Howes OD, et al. Treatment-Resistant Schizo

2、phrenia: Treatment Response and Resistance in Psychosis TRRIP Working Group Consensus Guidelines on Diagnosis and Terminology. Am J Psychiatry. 2016 Dec 6:appiajp201616050503.Hiemke C, Baumann P, Bergemann N,等. AGNP精神科治療藥物監(jiān)測(cè)共識(shí)指南:2020J. 實(shí)用藥物與臨床, 2016, 1910.Correll C U, Manu P, Olshanskiy V, et al. Ca

3、rdiometabolic Risk of Second-Generation Antipsychotics During First-Time Use in Children and AdolescentsJ. Jama the Journal of the American Medical Association, 2020, 30216:1765-1773.Page 3u兒童青少年精神分裂：起病年齡兒童青少年精神分裂：起病年齡1818歲的一種病因歲的一種病因未明，臨床上以根本個(gè)性改變、特征性思維障礙、未明，臨床上以根本個(gè)性改變、特征性思維障礙、感知覺(jué)異常、情感與環(huán)境不協(xié)調(diào)、孤獨(dú)性表現(xiàn)為主

4、感知覺(jué)異常、情感與環(huán)境不協(xié)調(diào)、孤獨(dú)性表現(xiàn)為主要特征的精神障礙。要特征的精神障礙。u兒童青少年精神分裂癥分為：兒童青少年精神分裂癥分為：起病年齡起病年齡13131818歲的早發(fā)性精神分裂癥歲的早發(fā)性精神分裂癥起病年齡起病年齡1313歲的兒童期發(fā)病的精神分裂。歲的兒童期發(fā)病的精神分裂。兒童青少年精神分裂癥的診斷，與成人一樣，不考兒童青少年精神分裂癥的診斷，與成人一樣，不考慮發(fā)病年齡。慮發(fā)病年齡。American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatmen

5、t of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2021 Sep;529:976-90.Page 4中華醫(yī)學(xué)會(huì)精神病學(xué)分會(huì). 精神分裂癥防治指南第二版.2021.140.American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia.

6、J Am Acad Child Adolesc Psychiatry. 2021 Sep;529:976-90.Page 5中華醫(yī)學(xué)會(huì)精神病學(xué)分會(huì). 精神分裂癥防治指南第二版.2021.140.American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2021 Sep;529:9

7、76-90.Page 6Howes OD, et al. Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis TRRIP Working Group Consensus Guidelines on Diagnosis and Terminology. Am J Psychiatry. 2016 Dec 6:appiajp201616050503.Page 7抗精神病藥抗精神病藥代謝酶代謝酶典型藥典型藥1A2、2D6阿立哌唑阿立哌唑2D6、3A4利培酮利培酮2D6、3A4喹硫平喹硫平2

8、D6、3A4氯氮平氯氮平1A2、2C19、3A4奧氮平奧氮平N-葡萄糖醛酸轉(zhuǎn)移酶、1A2、2D6帕利哌酮帕利哌酮1A2抑制劑：抑制劑：諾氟沙星、氟伏沙明、環(huán)丙沙星、誘導(dǎo)劑：誘導(dǎo)劑：卡馬西平、吸煙2D6抑制劑：抑制劑：帕羅西汀、奮乃靜、美托洛爾、氟西汀、度洛西汀、胺碘酮誘導(dǎo)劑：3A4抑制劑：抑制劑：氟伏沙明、紅霉素、胺碘酮誘導(dǎo)劑：誘導(dǎo)劑：卡馬西平、苯巴比妥、苯妥英2C19抑制劑：抑制劑：奧美拉唑、氟伏沙明、氟西汀、埃索美拉唑誘導(dǎo)劑：誘導(dǎo)劑：卡馬西平、銀杏葉、苯巴比妥、苯妥英Hiemke C, Baumann P, Bergemann N,等. AGNP精神科治療藥物監(jiān)測(cè)共識(shí)指南:2020J. 實(shí)

9、用藥物與臨床, 2016, 1910.Page 8中華醫(yī)學(xué)會(huì)精神病學(xué)分會(huì). 精神分裂癥防治指南第二版.2021.140.American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2021 Sep;529:976-90.Page 9Correll C U, Manu P, Olsh

10、anskiy V, et al. Cardiometabolic Risk of Second-Generation Antipsychotics During First-Time Use in Children and AdolescentsJ. Jama the Journal of the American Medical Association, 2020, 30216:1765-1773.Page 10Correll C U, Manu P, Olshanskiy V, et al. Cardiometabolic Risk of Second-Generation Antipsy

11、chotics During First-Time Use in Children and AdolescentsJ. Jama the Journal of the American Medical Association, 2020, 30216:1765-1773.Page 11American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am

12、 Acad Child Adolesc Psychiatry. 2021 Sep;529:976-90.Page 12中華醫(yī)學(xué)會(huì)精神病學(xué)分會(huì). 精神分裂癥防治指南第二版.2021.140.American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2021 Sep;529:976-

13、90.Page 13中華醫(yī)學(xué)會(huì)精神病學(xué)分會(huì). 精神分裂癥防治指南第二版.2021.140.American Academy of Child and Adolescent Psychiatry. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2021 Sep;529:976-90.Page 14首選指南推薦的非典型抗精神病藥，急性發(fā)作可以考慮首選指南推薦的非典型抗精神病藥，急性發(fā)作可以考慮短期使用氟哌啶醇，需慎重短期使用氟哌啶醇，需慎重EPSEPS和認(rèn)知功能和認(rèn)知功能多種藥物結(jié)合使用可按照不同藥理作用、不良反響、多種藥