Всемирная психиатрия. №3 2018

Коррекция распространенных побочных эффектов антипсихотических препаратов

T. Scott Stroup1, Neil Gray2

1New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA; 2Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA

Стр. 333-348

4119 просмотров

Опубликовано: 28 декабря 2018

Аннотация / Abstract

a:2:{s:4:"TEXT";s:65531:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:108613:"Перевод: Пикиреня Л.Ю. (Минск), Пикиреня В.И. (Минск) Редактура: к.м.н. Федотов И.А. (Рязань) Положительные эффекты антипсихотических препаратов иногда перекрываются неблагоприятными последствиями лечения. Эти последствия варьируют от относительно небольших проблем с переносимостью (например, умеренного седативного эффекта или сухости во рту) до очень неприятных (например, запора, акатизии, сексуальной дисфункции), болезненных (как, например, острое расстройство мышечного тонуса), уродующих (увеличения массы тела, поздней дискинезии), а также угрожающих жизни (например, миокардита или агранулоцитоза). Важно отметить, что профили побочных эффектов являются специфическими для каждого антипсихотического препарата и не полностью вписываются в классификацию антипсихотиков на препараты первого и второго поколений. В этой статье рассматриваются стратегии управления наиболее частыми побочными эффектами и определяются общие принципы, призванные оптимизировать положительные эффекты антипсихотиков. Антипсихотические препараты должны назначаться только при точных показаниях; продолжать применение антипсихотических препаратов следует при ощутимых преимуществах их воздействия. Если антипсихотик оказывает существенную пользу и побочный эффект от него не опасен для жизни, тогда первый метод регулирования его применения заключается в снижении дозы или корректировке графика дозирования. Следующий вариант – поменять антипсихотический препарат; это часто бывает разумным, если риск рецидива невысок. В некоторых случаях можно попытаться использовать поведенческую терапию. Наконец, во многих случаях необходимо применение сопутствующих лекарств, которые могут привести к значительному улучшению, хотя обычно их использование нежелательно. Среди таких методик лечения дистоний и паркинсонизма довольно часто эффективно применение антихолинергических препаратов; бета-блокаторы и антихолинергические препараты благопри...

Перевод: Пикиреня Л.Ю. (Минск), Пикиреня В.И. (Минск) Редактура: к.м.н. Федотов И.А. (Рязань) Положительные эффекты антипсихотических препаратов иногда перекрываются неблагоприятными последствиями лечения. Эти последствия варьируют от относительно небольших проблем с переносимостью (например, умеренного седативного эффекта или сухости во рту) до очень неприятных (например, запора, акатизии, сексуальной дисфункции), болезненных (как, например, острое расстройство мышечного тонуса), уродующих (увеличения массы тела, поздней дискинезии), а также угрожающих жизни (например, миокардита или агранулоцитоза). Важно отметить, что профили побочных эффектов являются специфическими для каждого антипсихотического препарата и не полностью вписываются в классификацию антипсихотиков на препараты первого и второго покол�...

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Вход / Регистрация

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