Hummel Jana, Lederbogen Florian
Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Mannheim.
MMW Fortschr Med. 2006 May 15;Spec no. 2:11-5; quiz 16.
The family physician is responsible for the primary medical care of a mentally ill person. Because these patients are frequently treated with antidepressants or antipsychotic drugs, the family physician should be well-informed of the indication, dosage and side effects of these substances. Among antidepressants, selective serotonin reuptake inhibitors (SSRI) and newer substances usually have a more favorable side effect profile than tricyclic antidepressants (TCA). Atypical antipsychotic drugs show a lower risk for extrapyramidal motor disorders in contrast to conventional antipsychotic drugs. Undesired effects such as weight gain can, however, occur in all substance groups. The treatment of somatic comorbidities in these mentally ill patients and, likewise, the prophylaxis to prevent recurrence of depressive and schizophrenic diseases are also the responsibility of the family physician.
家庭医生负责为精神疾病患者提供初级医疗护理。由于这些患者经常使用抗抑郁药或抗精神病药物进行治疗，家庭医生应充分了解这些药物的适应症、剂量和副作用。在抗抑郁药中，选择性5-羟色胺再摄取抑制剂（SSRI）和新型药物通常比三环类抗抑郁药（TCA）具有更有利的副作用特征。与传统抗精神病药物相比，非典型抗精神病药物出现锥体外系运动障碍的风险较低。然而，所有药物组都可能出现体重增加等不良影响。这些精神疾病患者的躯体合并症治疗以及预防抑郁和精神分裂症疾病复发的预防措施同样也是家庭医生的职责。
