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Schizophrenia
體重增加是最常見之副作用長期使用olanzapine抑制下視丘
毒性或過敏反應:粒性白血球缺乏症 (agranulocytosis),膽汁阻塞造成之黃疸 (cholestatic jaundice),及皮膚發疹clozapine較易造成粒性白血球缺乏症 可以致死用藥後6~18週發病,發病後很快就會造成病人死亡。每週的血液檢查不能疏忽,必須持續監測顆粒性白血球的濃度(因其進展快速)
眼球前部 (角膜及水晶體) 的沉澱為使用chlorpromazine,加重水晶體的老化程度
Thioridazine是唯一會造成視網膜沉澱造成色素沉澱視網膜炎,其發生之徵兆為視覺褐色化最大劑量為800 mg/d以減少此併發症之發生。
心臟毒性thioridazine之劑量超過300 mg/d時通常都會造成不正常之T wave,但此作用為可逆轉作用。心室心律不整thioridazine會造成病人不正常的ECG,long QT,abnormal ST & T waves。
抗精神病藥物惡性症狀 (neuroleptic malignant syndrome ,NMS)對第一代第二代藥物的錐體外症狀特別敏感時發生,吃的時候就會昏迷,汗腺容易失調,體溫飆高,在急診室時此類病患常會被誤診為一般的發炎反應而導致死亡,因此詢問病人病史(有無服用其他藥物)是相當重要的事。急救用肌肉鬆弛劑、鎮靜安眠劑,多巴胺致效劑


Olanzapine在精神分裂患者身上也被發現具有部分之抗憂鬱效果。(重要)一般而言,焦慮症的病人還是以使用一般鎮靜安眠藥為主。但是抗精神病藥物中的ziprasidone(第三代)在低劑量的情況下卻能有效且安全的抗焦慮。(必背)thioridazine會引起心血管疾病是他認為重要的。(必殺!!!)

Depression
TCA(異環類)=>SSRI=>



Cheese effect(起司效應)夜尿 (TCA 如imipramine)----必考SSRI是繼TCA後發明的新型抗憂鬱藥物,其中Fluoxetine(百憂解)<必考!!!>SSRI的五種藥物Fluoxetine (Prozac)、Paroxetine 、Sertraline 、Fluvoxamine 、Citalopram 要背

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