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女性精神障碍:精神药物治疗

Psychiatric disorders in women: psychopharmacologic treatments.

作者信息

Fankhauser M P

机构信息

Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson 85721-0207, USA.

出版信息

J Am Pharm Assoc (Wash). 1997 Nov-Dec;NS37(6):667-78. doi: 10.1016/s1086-5802(16)30277-7.

Abstract

OBJECTIVE

To review the most common psychiatric disorders in women and to address gender-related pharmacokinetic and pharmacodynamic differences in psychotropic medications.

DATA SOURCES

Recent clinical literature selected by the author.

DATA SYNTHESIS

Women have higher prevalence rates of anxiety, mood, and eating disorders than do men, and they are prescribed the majority of psychotropic medications. In general, women experience more comorbid illnesses, have a higher rate of morbidity and disability, and suffer more from reversible drug-induced or medically induced psychiatric conditions. Biological factors such as hormonal and neurotransmitter fluctuations during the menstrual cycle, pregnancy, postpartum, perimenopause, and postmenopause may affect the pharmacokinetics of psychotropic medications. Information is needed about gender differences in the incidence and diagnosis of psychiatric disorders; sex differences in the treatment, response, pharmacokinetics, and adverse effects of psychotropic medications; and safety of psychotropic medications in the fetus and in the breast-fed infant.

CONCLUSION

An understanding of the impact of physiologic, hormonal, and neurotransmitter changes associated with different life phases should provide valuable insight into the treatment of neuropsychiatric disorders in women and gender differences in psychopharmacology.

摘要

目的

回顾女性中最常见的精神障碍,并探讨精神药物中与性别相关的药代动力学和药效学差异。

资料来源

作者选择的近期临床文献。

资料综合

女性焦虑症、情绪障碍和饮食失调的患病率高于男性,并且大多数精神药物都开给了女性。一般来说,女性患合并症更多,发病率和残疾率更高,并且更容易受到可逆性药物诱导或医源性精神疾病的影响。月经周期、怀孕、产后、围绝经期和绝经后期的激素和神经递质波动等生物学因素可能会影响精神药物的药代动力学。需要了解精神障碍发病率和诊断方面的性别差异;精神药物治疗、反应、药代动力学和不良反应方面的性别差异;以及精神药物对胎儿和母乳喂养婴儿的安全性。

结论

了解与不同生命阶段相关的生理、激素和神经递质变化的影响,应为女性神经精神障碍的治疗以及精神药理学中的性别差异提供有价值的见解。

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