Dr. Beck and Dr. Steer Reply
Dr. Beck and Dr. Steer Reply
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贝克博士和斯蒂尔博士回复
DOI：
10.1176/ajp.147.11.1577-a
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发表时间：
1990
影响因子：
17.7
通讯作者：
R. Steer
中科院分区：
文献类型：
--
作者：
A. Beck;R. Steer
第147章：一个人11，1990年11月1577令人生畏的问题：在老年人的精神药理学治疗中做出临床决策的适当算法是什么？卡马西平血清浓度及其在MAOI存在下的变异性问题只是作者病例报告中关于疗效和毒性的众多问题之一。卡马西平是脑卒中后抑郁的一线治疗药物吗？三种精神活性药物是否应该在治疗这种疾病的第一步使用（2）？卡马西平和锂联合用药安全吗（3）？关于坎卡马西平和苯乙肼或其他MAOIs联合用药的药效学影响，坎卡马西平的血药浓度是否是唯一相关的风险因素（即，在泮托拉唑中，脱钙、体位性低血压和高血压危象的风险是什么）？三环结构与三环类抗抑郁药相似的坎巴西平与MAOI同时使用时是否会增加高血压危象的风险？此外，在这种情况下，卡马西平和苯乙肼的组合是必要的，因为苯乙肼单独或不治疗可能同样有效？
Am J Psychiatry 147: 1 1, November 1990 1577 daunting question: what are the appropriate algorithms for making clinical decisions in psychopharmacologic treatment of the elderly? The issue of carbamazepine serum level and its variability in the presence of MAOIs is only one of a number of questions regarding efficacy and toxicity in the authors’ case report. Is carbamazepine an appropriate first-line treatment for poststroke depression? Should three psychoactive pharmaceuticals be used during the first step of a treatment strategy for this disorder(2)? Is the carbamazepine and lithium combination safe (3)? Is the blood level of canbamaze-pine the only relevant risk factor with respect to the pharmacodynamic impact of canbamazepine and phenelzine or other MAOIs in combination(ie, what are the risks of de-linium, postural hypotension, and hypertensive crisis, in pan-ticulan)? Does canbamazepine, with its tnicyclic structure not dissimilar to that of tnicyclic antidepressants, adversely po-tentiate the risk of hypertensive crises when it is used con-comitantly with MAOIs? Moreover, was the combination of carbamazepine and phenelzine in this case necessary, as phenelzine alone or no treatment might have worked equally well?