Genel Tıbbi Duruma ve Maddeye Bağlı Psikotik Bozukluklarda Tedavi
Genel Tıbbi Duruma ve Maddeye Bağlı Psikotik Bozukluklarda Tedavi
Genel Tıbbi Duruma ve Maddeye Bağlı Psikotik Bozukluklarda Tedavi
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Intl Psychopharmacology<br />
Algorithm Project<br />
.<br />
yes to any issue<br />
Now...or at Any Time:<br />
Critical initial or emergent issues that impact<br />
management and choice of drugs.<br />
A. major suicide risk<br />
B. catatonia or NMS<br />
C. se<strong>ve</strong>re agitation or violence<br />
D. noncompliance<br />
E. depression or mood symptoms<br />
F. substance abuse<br />
G. prodromal or first episode<br />
H. antipsychoticinduced sideeffects<br />
1. Diagnosis of schizophrenia or<br />
schizoaffecti<strong>ve</strong> disorder<br />
2. Evaluate for major suicide risk, catatonia, se<strong>ve</strong>re agitation or<br />
violence, noncompliance, depression or mood symptoms,<br />
substance abuse, antipsychoticinduced sideeffects, prodromal<br />
or first episode?<br />
3. Initiate 46 week trial of Low Dose atypical (<br />
OLANZ, RISP or ZIP) + Pimavanserin<br />
no<br />
4. Adequate trial?<br />
yes<br />
5. Psychosis or medically unacceptable sideeffects<br />
persist after adjusting dose?<br />
no<br />
no<br />
yes<br />
6. Initiate second 46 week trial full<br />
dose second atypical, if available<br />
7. Adequate trial?<br />
yes<br />
8. Psychosis, moderateto<br />
se<strong>ve</strong>re TD or tardi<strong>ve</strong> dystonia<br />
after adjusting dose?<br />
yes<br />
9. 6 month trial of CLOZ<br />
10. Persistent positi<strong>ve</strong><br />
symptoms?<br />
yes<br />
11. Switch to Hi Dose Olanz or CLOZ<br />
Augment with ECT or adjuvant medication;<br />
alternate strategies<br />
no<br />
no<br />
no<br />
12. Begin<br />
maintenance<br />
treatment.<br />
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