Abstract: Quetiapine treatment of adult schizophrenia has been reported too, but its application of schizophrenia in children is rarely reported. The development of children and adults with physical and mental development of very different, so we compared quetiapine in adults and children schizophrenia and adverse reactions are reported below. Number of pages: 2 Page Range :166-167 Key words: comparative efficacy of childhood schizophrenia treatment of quetiapine side effects adult subject classification: R749.94 [medicine, HEALTH "Neurology and Psychi Psychi Child mental illness] R683.42 [medicine, HEALTH "outside SCIENCES" Orthopaedic Surgery (Sports Department diseases, orthopedics)> fracture, bone da fract lower extremity fractures] Related Articles: Topics related references (7) is cited situation (a) coupling the literature (17)
Five common problems of drug treatment of schizophrenia Detailed paranoid schizophrenia patients before and after 2 months post-operative . Shen aware of their small mistakes before, shame . the spirit of the Tang were 426 cases of hospital surgery Clinical follow schizophrenia "complete cure" on their own, "I want to go home" appeal to the community concerned about the weight of the mentally ill . how to care for paranoid schizophrenia patients at the end of suspicion, doubt an early manifestation of schizophrenia .
Schizophrenia in terms of biological or methodological point of , is a very complex disease. Path
ogenesis of schizophrenia, treatment and prevention, has been the subject of psychiatric research center. The traditional medical model of the biological of the cause, according to this , schizophrenia is a disease of unknown cause. because, since the discovery of pathogenic microorganisms, people accustomed to the cause of various diseases are as a single factor, if you can not find a single cause to as "unknown etiology." Many common diseases can be considered to be unknown etiology such as hypertension, gastric ulcer. schizophrenia fall into this category of course. However, there has been the traditional concept of change, reflected in the 20th century 70 years since the disease patterns change, the original bio-medical model to bio – psycho – social medical model. This means that for most diseases, its incidence is not absolutely dependent on a single factor, such as M. tuberculosis infection After the tuberculosis bacteria does not necessarily (in fact most are not suffering from tuberculosis), whether the illness was also decided that in my mental and physical condition, which in turn are closely related and their environmental conditions. to schizophrenia is concerned, some people think It is also caused by the combined effects of many factors.
The treatment of schizophrenia, antipsychotic drugs play an important role. Supportive psychotherapy, to improve the patient”s social environment as well as improving patient rehabilitation measures of social adaptive capacity, is also very important. Usually in the acute stage, drug treatment is Lord. chronic phase, psycho-social rehabilitation measures to prevent recurrence and improve the ability of social adaptation of patients have a very important role.Drug treatment
Antipsychotics, also known as nerve blockers, can effectively control the psychotic symptoms of schizophrenia is widely used in clinical, psychiatric symptoms significantly improved response rate and discharge rate of the mentally ill. The most commonly used antipsychotic, the earliest In the 20th century, found there to 50 years as the representative of chlorpromazine phenothiazine (Phenothiazine) drugs; followed by haloperidol appeared as the representative of butyrylcholinesterase benzene (Butyrophenone), as well as general thiophene tons of chlorine ( Tai Erdeng) anthracene as the representative of thia class (Thioxanthene) drugs. according to clinical effect, and can be divided into two types of inefficient price and high price. The former, represented by chlorpromazine, the sedative effect of strong excitement and anti-anti- hallucination delusion obvious, less extrapyramidal side effects, but effects on cardiovascular and liver function was more obvious features of the larger dose. The second class to haloperidol, trifluoperazine represented. class of drugs Anti-hallucinations, delusions more prominent role, extrapyramidal side effects more serious, no sedation, anti-excitatory effect on the visceral side effects of light. Also found benzamides (Benzamide) of sulpiride (sulpiride) is also effective antipsychotic .
The choice of drugs should take into account the clinical characteristics and status of the patient”s physical characteristics.
(1) acute drug treatment system: the first onset or relapse after remission in patients with antipsychotic treatment system and seek the full, in order to get deeper in clinical remission. General course of 8 to 10 weeks. Commonly used antipsychotics doses are as follows:
Chlorpromazine: dose is generally 300 ~ 400mg/d.60 dose over the age of the elderly, generally for adults, 1 / 2 or 1 /
perphenazine: In addition to sedation than chlorpromazine, the other with chlorpromazine. On the cardiovascular system, liver and hematopoietic system side effects than chlorpromazine light. For the elderly, patients with poor body condition. Adult Treatment the amount of 40 ~ 60mg / d.
Trifluoperazine: drugs not only without sedation, on the contrary there is excitement, activation. There was the role of anti-illusion delusion. On the behavior of withdrawal, apathy and other symptoms have some effect. For paranoid schizophrenia and chronic schizophrenia . adult dose of 20 ~ 30mg / d.
haloperidol: a butyrylcholinesterase benzene drugs. The medicine more quickly control psychomotor excitement, the role of anti hallucinations delusions, chronic symptoms have some effect. Extrapyramidal side effects more apparent. Adult therapeutic dose of 12 ~ 20mg / d.
Flupentixol (trifluoromethyl thiophene tons, rehabilitation Su): the drug on negative symptoms better. Dose of 10 ~ 20mg / d. date volume of 20mg or more, prone to extrapyramidal side effects. On the hematopoietic system, liver and kidney without toxic effects. rapid onset, 2 weeks effective.
beads chlorthalidone tons (chlorthalidone tons of high resistance elements): the drug of delusions, hallucinations, and excitement, impulsivity and other behavioral disorders better. Each 10mg, therapeutic dose of 40 ~ 80mg / d. rapid onset, 1 weeks, there may be effects.
Clozapine: antipsychotic because of its significant role, and extrapyramidal side effects is very light, and began to be used clinically. The main drawback is that there may be a lack of neutropenia or the side effects, there rate of about 1%. The need for regular testing, treatment must begin 2 months 1 week 3 months 1 time every 2 weeks required. Once neutropenia, should be immediately discontinued. domestic and international double-blind study data showed that acute schizophrenia Clozapine symptoms such as equal to the same effect and chlorpromazine, but more effective than chlorpromazine in refractory schizophrenia (Meltzer HY, 1995). abroad refractory schizophrenia for 6 weeks double-blind, multi-center data ( Kane, 1988), found that clozapine 600mg / d is more effective than chlorpromazine 1200mg / d, the former is 20% effective, which is 4%. commonly used dose of 300 ~ 400mg / d.
Sulpiride (Sulpiride): overall clinical efficacy and chlorpromazine is close to control hallucinations, delusions, thinking outside the effective barriers to improving patient mood, there are s with the people around treatment. Treatment average dose of 600 ~ 800mg / d .20 the 90 years since the emergence of a new second-generation antipsychotics. pharmacological effects of these drugs is not limited to D2 receptors, also acts on 5-HT2 receptor and other receptors. which is characterized by extrapyramidal side effects significantly lower than the first generation.
risperidone (Risperdal): is the balance 5-HT2/D2 receptor antagonist. Its main advantages are less extrapyramidal side effects, in addition to other positive symptoms of delusions and effective, but also improve the negative symptoms. Domestic and more center study found that risperidone in the treatment of positive symptoms of schizophrenia and negative symptoms are valid, the patients tolerated the drug and the compliance is also better (care of cattle Fan, 1998). Adult Treatment dose is 3 ~ 4mg / d, individual up to 6mg / d.
olanzapine (Ao Lanzha level): the role of the D4, D3, D2 receptor and 5-HT2 receptors. More advantage of clozapine is agranulocytosis without serious side effects, no extrapyramidal side effects. domestic clinical study found that olanzapine on positive and negative symptoms and general mental ill have a good effect, fewer extrapyramidal side effects (Shu Liang, 1999). adult therapeutic dose of 5 ~ 20mg / d.To continue treatment
Continue treatment: psychiatric symptoms during the acute phase has been controlled, should continue to use doses of antipsychotic medication for 1 month or so, in order to make conditions for further relief. And then gradually reducing maintenance therapy.Primary prevention is taken from the cause of the pathogenesis of measures to prevent diseases, but the incidence of schizophrenia and pathogenesis of the reasons not fully elucidated, so difficult to implement in primary prevention.Secondary prevention
Primary prevention of schizophrenia have not been able to implement before the focus should be on prevention of early detection, early treatment and prevention of recurrence. So to establish mental control agencies in the community, popular among the masses, prevention and treatment of mental illness, the elimination of mental discrimination of patients, the is not correct, so that patients can get early detection and early treatment. in return to society, to mobilize the family and social forces to create the conditions for the rehabilitation of patients. rehabilitation in the community under the guidance and training in family support , increasing social adaptation of patients to reduce psychological stress, adhere to medication, to prevent recurrence and reduce disability. both domestic and international experience shows the importance and feasibility.Tertiary prevention
Tertiary prevention refers primarily rehabilitation, refers to the use made of the conditions and timing as much as possible to take comprehensive measures to enable patients to maximize functional recovery. Schizophrenic patients relapse rate, time to take effective measures to try to make the patient does not relapse or less recurrence, is an important preventive measures available from the following aspects:
1, psychological treatment before discharge: In the majority of schizophrenic patients who were hospitalized after the disappearance of psychiatric symptoms, insight partially restored, through psychotherapy, to help patients understand their own changes in psychiatric symptoms, and encouraged the confidence to overcome the disease the patient Shuli Church of patients some of the methods of relapse prevention.
2, the family members of patients for health education of patients to medical care and psychological support for the guarantee.
3, establish a regular out-patient follow-up system to guide the maintenance treatment of patients taking the right amount of drugs, by drug treatment to prevent relapse, studies show that maintenance medication treatment can effectively reduce the recurrence rate.
4, raise the level of community mental health knowledge, you can start from the community mental health knowledge of missionary work, in conditions of communities work-rehabilitation centers during the day for schizophrenia patients to create a good social environment to help them return to Social
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