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[关于在2019冠状病毒病大流行期间使用精神药物的建议]

[Recommendations about the Use of Psychotropic Medications during the COVID-19 Pandemic].

作者信息

Andrade Gabriela, Simões do Couto Frederico, Câmara-Pestana Luis

机构信息

Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte. Lisboa; Clínica Universitária de Psiquiatria e Psicologia Médica. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte. Lisboa. Instituto de Farmacologia e Neurociências. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

出版信息

Acta Med Port. 2020 Oct 1;33(10):693-702. doi: 10.20344/amp.13976. Epub 2020 Jul 23.

Abstract

INTRODUCTION

The COVID-19 pandemic is a particularly relevant threat to mentally ill patients, and it constitutes a new challenge for health care providers. To the best of our knowledge, there is not any embracing published review about the use of psychotropic drugs during the COVID-19 pandemic.

MATERIALS AND METHODS

Non-systematic literature review. A search in the PubMed database was performed, with the terms 'psychotropic drugs', 'COVID-19', 'psychiatry' and 'pandemic'. Consensus and clinical guidelines about psychotropic drugs and COVID-19 approach, published by scientific societies, governmental entities and drug regulatory agencies were included.

RESULTS AND DISCUSSION

We present the recommendations about the use of psychotropic drugs during the COVID-19 pandemic, in the outpatient and inpatient settings. The treatment of affective bipolar disorder and schizophrenia have now added increased difficulties. Some psychotropic drugs interfere with the pathophysiology of the novel coronavirus infection and they could interact with the drugs used in the treatment of COVID-19. Some patients will need pharmacological interventions due to the presence of delirium. Smoking cessation changes the serum levels of some psychotropic drugs and may influence their use.

CONCLUSION

The COVID-19 pandemic has created new challenges in clinical practice. Psychiatric patients are a vulnerable population and often a careful clinical, laboratorial and electrocardiographic evaluation may be needed, particularly in those diagnosed with COVID-19. The regular treatment of mentally ill patients with COVID-19 presents increased complexity.

摘要

引言

新型冠状病毒肺炎疫情对精神病患者构成了特别严重的威胁,对医疗服务提供者来说也是一项新挑战。据我们所知,目前尚无关于新型冠状病毒肺炎疫情期间使用精神药物的全面发表的综述。

材料与方法

非系统性文献综述。在PubMed数据库中进行检索,检索词为“精神药物”“新型冠状病毒肺炎”“精神病学”和“疫情”。纳入了科学协会、政府实体和药品监管机构发布的关于精神药物及新型冠状病毒肺炎应对方法的共识和临床指南。

结果与讨论

我们介绍了新型冠状病毒肺炎疫情期间在门诊和住院环境中使用精神药物的建议。情感性双相障碍和精神分裂症的治疗现在增加了难度。一些精神药物会干扰新型冠状病毒感染的病理生理过程,并且可能与用于治疗新型冠状病毒肺炎的药物相互作用。一些患者因出现谵妄而需要药物干预。戒烟会改变一些精神药物的血清水平,可能影响其使用。

结论

新型冠状病毒肺炎疫情给临床实践带来了新挑战。精神病患者是弱势群体,通常可能需要进行仔细的临床、实验室和心电图评估,尤其是那些被诊断为新型冠状病毒肺炎的患者。对患有新型冠状病毒肺炎的精神病患者进行常规治疗的复杂性增加。

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