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Maudsley精神病处方实用指南(翻译版)
$41.81
《Maudsley精神病高级处方指南》一书聚焦于患者的个体化治疗,作者们都是该领域的知名专家。相对于精神病性障碍“一刀切式”的治疗,他们提供了另外一种选择,并展示如何建立医患关系,从而制订有效的个体化治疗计划。本书的主要作用如下:1.有助于为出现精神病性症状的患者制订适当的治疗计划。2.提供进行比较的方法,有助于衡量不同治疗方案的适用性。3.对常用抗精神病药提供随手可查的数据和信息。4...
《Maudsley精神病高级处方指南》一书聚焦于患者的个体化治疗,作者们都是该领域的知名专家。相对于精神病性障碍“一刀切式”的治疗,他们提供了另外一种选择,并展示如何建立医患关系,从而制订有效的个体化治疗计划。本书的主要作用如下:1.有助于为出现精神病性症状的患者制订适当的治疗计划。2.提供进行比较的方法,有助于衡量不同治疗方案的适用性。3.对常用抗精神病药提供随手可查的数据和信息。4.解释了每种药物不良反应的来源。《Maudsley精神病高级处方指南》为精神科医生及其他精神卫生专业人员提供了从个体水平治疗精神病性障碍的基础指南。
本书秉承基于循证的原则,描述了临床精神病学实践中的常见问题,提供了处理策略,旨在为治疗精神病性障碍提供个体化的方法。对于常用的治疗精神性障碍和双相障碍的药物,本书提供了数据和指导,也为处方者和患者提供了所需要的工具,以便他们权衡各种治疗选择的成本和效益,找出适合患者具体需求的治疗计划。书中主要介绍了不同疾病及不同病程阶段对各类精神科药物的使用及不良反应等,同时本书的附录提供了包含这些数据的表格。作为药物选择和药物不良反应的指导性工具书,本书内容实用,译者团队专业,对精神科医生、精神卫生从业者的临床实践有重要指导价值。
司天梅,主任医师,教授,博士,博士生导师。现任北京大学第六医院副院长,北京大学第六医院临床药理研究室主任,中华医学会精神医学分会常委兼秘书长,中国医师协会精神科医师 分会常委,精神药理学和药物治疗学专业委员会组长,中国神经科学会精神病学基础与 临床专业委员会常委,亚洲精神分裂症研究学会当选主席。《Maudsley精神科处方指南》主译。
第1章精神病性障碍/11.1什么是精神病性障碍?/11.2自知力缺失/11.3精神病的原因/11.4精神分裂症:人格丧失与社会心理功能衰退/21.5双相情感障碍/31.6大麻、合成大麻素和精神病/3第2章精神病性障碍的循证治疗/52.1传统医学/52.2随机对照试验/52.3社区治疗/52.4治疗策略与个性化治疗/6第3章抗精神病药/73.1精神病性障碍的药理学基本原理/73.2神经递质及其受体/93.3药物选择/103.4急性精神病发作/113.5维持期:预防复发/153.6长效抗精神病药的应用/203.7长效抗精神病药的处方原则/20第4章双相情感障碍/294.1双相情感障碍的诊断/294.2躁狂的治疗/304.3双相抑郁的治疗/304.4双相情感障碍的维持治疗阶段:预防复发/314.5育龄女性的双相情感障碍/35第5章心理治疗在精神病性障碍治疗中的作用/375.1精神分析见解/375.2心理治疗/37第6章抗精神病药治疗的不良反应/396.1体重增加/396.22型糖尿病/406.3血脂异常/426.4运动系统不良反应/426.5高催乳素血症/446.6性功能方面的不良反应/456.7QTc间期延长/466.8抗精神病药恶性综合征/48第7章服务机构:特定路径的治疗/497.1背景/497.2精神疾病危险期/497.3早期干预服务机构/507.4急性期服务机构/507.5持续照护服务机构:促进康复/51第8章治疗结局的评估/538.1基于价值的医疗/538.2循证医疗管理/54附录1部分精神药物的药代动力学/55附录2代谢综合征/61附录3服用抗精神病药患者的躯体健康监测/63附录4服用心境稳定剂患者的躯体健康监测/65参考文献/67
制订处方指南的前提是,所有具有特定诊断的个体都患有相同的疾病,并且具有共同的潜在机制。在普通内科中,这是理所当然的,甚至不是问题。而对于精神病的治疗,事情就并非那么简单了。与普通内科疾病相比,以一成不变的方法治疗精神病是不可行的。精神病可发生在各种不同的精神科疾病中,包括精神分裂症、双相情感障碍、抑郁症和强迫症等。精神病性体验可发生在正常人身上,但也可能是严重器质性疾病的标志,例如针对脑组织中特定离子通道的抗体。在本书中,我们强调精神病的治疗必须针对患者的需求而量身定制。尽管精神病的分类仍然存在问题,药物治疗却并非如此。从20 世纪50 年代初期开始,在20 年左右的时间里,出现了真正有效的治疗精神科综合征的药物,首次使得改善(而不仅仅是镇静)躁狂、思维障碍、妄想、幻觉、自我界限瓦解等症状成为可能。而且几年以后人们发现,维持治疗可以预防精神病复发,不需要再次住院治疗。目前,有多种精神药物可供患者选择,这些药物各不相同。我们选择药物的策略通常是对比每种药物的优劣。理想的情况是,医生和患者能够权衡每种药物的治疗效果和成本,共同制订治疗方案。根据药物治疗的目的,我们将急性期与维持期区分开来。在急性期,症状缓解是首要任务。在维持期,其目的是避免复发,因为复发除了给患者带来更多痛苦之外,还预示着功能结局不良。如果不使用药物维持治疗,约80%~90% 的双相情感障碍或精神分裂症患者会复发。使用药物维持治疗的话,复发风险则降低到5%~40%。与急性期相比,维持期进行真正的合作更具有可行性,这在双相情感障碍中尤为明显。本书有相应的章节介绍广泛使用的抗精神病药(特别是抗精神病作用强的药物氯氮平)的常见不良反应。目的是为医生、关怀协调员、患者及其家人提供随手可查的资料。我们对每种不良反应发生的分子机制进行了简要说明,以帮助他们理解和参与决策制订。宗旨是为患者提供准确的数据,以便他们能够自己做出明智的医疗决策。本书后两章将重点从个体转移到群体和治疗体系。任务是通过资源配置达到以小成本获得收益。我们介绍了基于价值的医疗保健原则,并强调了医疗保健系统中的工程原理。这两方面的进展有望使得医疗保健管理具有科学依据。在选择药物时,手边有基本、准确的数据非常有用,其中涵盖了每种药物的药代动力学、相互作用和需要做的身体健康检查。为此,在本书的结尾,我们提供了包含这些数据的表格,希望能够帮助临床工作繁重的精神科医生和药剂师精确选择药物。
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