Westermeyer Joseph
University of Minnesota Staff Psychiatrist, Minneapolis VA Health Care Center, Minneapolis, MN.
J Nerv Ment Dis. 2019 Jan;207(1):45-47. doi: 10.1097/NMD.0000000000000909.
Psychiatric care has entered a new era in which care for treatment-resistant psychiatric disorder has attained priority status. Addressing treatment resistance involves 1) alleviating symptoms and signs of the diagnostic condition, 2) returning the patient to functional capacity, and 3) preventing subsequent recurrence. This approach has achieved considerable momentum in regard to major depressive disorder, as evidenced by early recognition and timely treatment, medication augmentation strategies, mind-body training for the populace at large, effective and efficient psychotherapies, and new biomedical interventions. This report proposes a pharmacotherapy that may qualify for treatment-resistant psychosis, that is, high-dose olanzapine. Considerable thought, planning, resources, and effort would be necessary to test this intervention. This proposal includes suggestions for developing an affordable means of assessing this and future candidates for treatment-resistant psychosis.
精神科护理已进入一个新时代，其中对难治性精神障碍的护理已获得优先地位。应对治疗抵抗涉及：1）缓解诊断疾病的症状和体征；2）使患者恢复功能能力；3）预防随后的复发。这种方法在重度抑郁症方面已取得了相当大的进展，早期识别和及时治疗、药物增效策略、针对广大民众的身心训练、有效且高效的心理治疗以及新的生物医学干预措施都证明了这一点。本报告提出了一种可能适用于难治性精神病的药物疗法，即高剂量奥氮平。测试这种干预措施需要进行大量的思考、规划、资源投入和努力。本提议包括关于开发一种经济实惠的方法来评估这种以及未来难治性精神病候选治疗方法的建议。
