Melamed Yuval, Finkel Boris, Barak Yoram, Zipris Patricia, Oyffe Igor, Weizman Abraham, Bleich Avi
Lev Hasharon Mental Health Center, Beilinson Hospital affiliated to the Sackler Faculty of Medicine, Tel Aviv University.
Harefuah. 2005 Apr;144(4):285-90, 301.
Schizophrenia is a severely limiting chronic illness. The disease is characterized by periods of psychoses, remission, and sometimes even recovery. Effective pharmacotherapy for schizophrenia began with the development of antipsychotic neuroleptics in the 1950's, followed by the second generation of antipsychotic agents developed in the 1990's. Across time, treatment with some of these preparations revealed extrapyramidal and other side effects, including metabolic phenomenon, such as: an increase in the incidence of diabetes, and weight gain. When choosing the appropriate medication from among the second generation of antipsychotic agents, the following aspects should be considered; cost, efficacy, unique advantages, employment rehabilitation, relapse and metabolic side effects. Therapeutic algorithms and recommended guidelines are helpful when planning treatment strategies. Information regarding prior beneficial treatments, cost, and the patient's quality of life should be considered. Today, when patients' rights, economic and legal aspects are emphasized, the physician must take into account multiple factors when choosing the most appropriate treatment for the patient.
精神分裂症是一种严重限制患者生活的慢性疾病。该疾病的特征是存在精神病发作期、缓解期,有时甚至会康复。精神分裂症的有效药物治疗始于20世纪50年代抗精神病神经阻滞剂的研发,随后是20世纪90年代开发的第二代抗精神病药物。随着时间的推移,使用其中一些药物进行治疗时发现了锥体外系及其他副作用,包括代谢方面的现象,如:糖尿病发病率增加和体重增加。在从第二代抗精神病药物中选择合适的药物时,应考虑以下几个方面:成本、疗效、独特优势、就业康复情况、复发率以及代谢副作用。在制定治疗策略时,治疗算法和推荐指南会有所帮助。应考虑有关既往有效治疗、成本以及患者生活质量的信息。如今,当强调患者权利、经济和法律方面时,医生在为患者选择最合适的治疗方法时必须考虑多个因素。