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停用精神药物的潜在不良反应。

Potential adverse effects of discontinuing psychotropic drugs.

作者信息

Howland Robert H

机构信息

University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.

出版信息

J Psychosoc Nurs Ment Health Serv. 2010 Sep;48(9):11-4. doi: 10.3928/02793695-20100730-04. Epub 2010 Aug 23.

Abstract

For nurses in clinical practice, understanding the pharmacology of drugs their patients take is relevant to understanding their therapeutic uses, side effect profiles, and adverse discontinuation effects. In this article, the last of a four-part series, the discontinuation effects of the following psychotropic drugs are described: benzodiazepine drugs (which have hypnotic, anti-anxiety, and anticonvulsant effects), non-benzodiazepine drugs (used for insomnia), glutamate-modulating drugs, opioid receptor agonist drugs (used as analgesics for the treatment of various pain conditions), and stimulant drugs. Serious adverse effects are likely to occur only after abrupt discontinuation of benzodiazepine drugs, and they should almost always be tapered. Prominent discontinuation effects are seen with opioid and stimulant drugs, but these are usually not serious. Tapering medication, rather than abruptly stopping them, can avoid or minimize the potential adverse discontinuation effects associated with most psychotropic drugs.

摘要

对于临床实践中的护士而言,了解患者所服用药物的药理学知识,有助于理解这些药物的治疗用途、副作用情况以及停药不良反应。本文是一个四部分系列文章的最后一篇,描述了以下精神药物的停药效应:苯二氮䓬类药物(具有催眠、抗焦虑和抗惊厥作用)、非苯二氮䓬类药物(用于治疗失眠)、谷氨酸调节药物、阿片受体激动剂药物(用作镇痛药治疗各种疼痛病症)以及兴奋剂药物。严重的不良反应仅可能在突然停用苯二氮䓬类药物后发生,而且几乎总是应该逐渐减量停药。阿片类药物和兴奋剂药物会出现明显的停药效应,但这些效应通常并不严重。逐渐减少药物剂量,而非突然停药,可以避免或尽量减少与大多数精神药物相关的潜在停药不良反应。

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