{"id":2491,"date":"2019-08-12T17:08:23","date_gmt":"2019-08-12T17:08:23","guid":{"rendered":"https:\/\/curesz.org\/?page_id=2491"},"modified":"2023-08-28T09:09:24","modified_gmt":"2023-08-28T13:09:24","slug":"messamore-clozapine-question-and-answer","status":"publish","type":"page","link":"https:\/\/curesz.org\/zh\/messamore-clozapine-question-and-answer\/","title":{"rendered":"Messamore \u6c2f\u6c2e\u5e73\u95ee\u7b54"},"content":{"rendered":"

\u5173\u4e8e\u6c2f\u6c2e\u5e73\u7684\u95ee\u7b54
\n(PDF<\/a>)<\/p><\/h1><\/div><\/div><\/div><\/div><\/div>

\u6458\u81ea CURESZ \u65f6\u4e8b\u901a\u8baf\u6c2f\u6c2e\u5e73\u7cfb\u5217
\n\u5728 Erik Messamore \u535a\u58eb\u7684\u7b2c 1-4 \u671f\u4e2d<\/div><\/h1><\/div><\/div><\/div><\/div><\/div>
<\/span><\/div><\/div><\/div>

\u57c3\u91cc\u514b\u00b7\u6885\u8428\u83ab\u5c14<\/a> \u662f\u4e1c\u5317\u4fc4\u4ea5\u4fc4\u533b\u79d1\u5927\u5b66\u7684\u7cbe\u795e\u75c5\u5b66\u5bb6\u548c\u7cbe\u795e\u75c5\u5b66\u526f\u6559\u6388\u3002\u4ed6\u62c5\u4efb\u5927\u5b66\u7cbe\u795e\u5206\u88c2\u75c7\u6cbb\u7597\u6700\u4f73\u5b9e\u8df5 (BeST) \u4e2d\u5fc3\u7684\u533b\u5b66\u4e3b\u4efb\u3002\u4ed6\u62e5\u6709\u836f\u7406\u5b66\u533b\u5b66\u535a\u58eb\u548c\u535a\u58eb\u5b66\u4f4d\u3002 Messamore \u535a\u58eb\u8fd8\u66fe\u5728 CURESZ \u57fa\u91d1\u4f1a\u8463\u4e8b\u4f1a\u4efb\u804c\u3002<\/p>\n<\/div><\/div><\/div><\/div><\/div>

\u7b2c\u56db\u4e2a\u90e8\u5206\u4e4b\u4e00<\/h1><\/div>

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To address her fear of needles, I prescribed an anesthetic cream that we would rub into the spot where we were would draw blood. The anesthetic cream numbed the skin and helped Anna feel comfortable with blood testing so she agreed to try clozapine.<\/p>\n

\u4e0d\u5230\u4e24\u4e2a\u6708\uff0c\u6211\u4eec\u5c31\u89c1\u5230\u4e86\u771f\u6b63\u7684\u5b89\u5a1c\u3002\u5979\u662f\u4e00\u4f4d\u4ee4\u4eba\u6109\u5feb\u7684\u5973\u58eb\uff0c\u6709\u5e7d\u9ed8\u611f\u3002\u81ea\u751f\u75c5\u4ee5\u6765\uff0c\u5979\u7b2c\u4e00\u6b21\u80fd\u591f\u79ef\u6781\u53c2\u4e0e\u5979\u7684\u51fa\u9662\u8ba1\u5212\u3002<\/p>\n

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\u51fa\u4e8e\u5404\u79cd\u539f\u56e0\uff0c\u7f8e\u56fd\u7684\u8bb8\u591a\u533b\u751f\u4e0d\u5411\u4ed6\u4eec\u7684\u7cbe\u795e\u5206\u88c2\u75c7\u60a3\u8005\u63d0\u4f9b\u6c2f\u6c2e\u5e73\u3002\u8fd9\u4e9b\u5929\u6211\u7684\u90e8\u5206\u5de5\u4f5c\u662f\u534f\u52a9\u533b\u751f\u6216\u7cbe\u795e\u79d1\u6267\u4e1a\u62a4\u58eb\u4f7f\u7528\u6c2f\u6c2e\u5e73\uff0c\u8ba9\u4ed6\u4eec\u4eb2\u773c\u770b\u5230\u50cf\u5b89\u5a1c\u8fd9\u6837\u7684\u6210\u529f\u6848\u4f8b\u5b9e\u9645\u4e0a\u5f88\u5e38\u89c1\u8fd9\u79cd\u72ec\u7279\u6709\u6548\u7684\u836f\u7269\u3002<\/p>\n<\/div><\/div><\/div><\/div><\/div>

\u56db\u90e8\u5206\u4e2d\u7684\u7b2c\u4e8c\u90e8\u5206<\/h1><\/div>

\u95ee\uff1a\u6c2f\u6c2e\u5e73\u6709\u65f6\u88ab\u79f0\u4e3a\u201c\u7075\u4e39\u5999\u836f\u201d\u3002\u4f60\u540c\u610f\u5417\uff1f<\/h1><\/div>

I’m not a fan of labels like “wonder drug” for medications. The most successful outcomes are usually the result of treatment that combines multiple approaches like psychotherapy, environmental modification, bolstering social support, and helping people to reconnect to the things in life that give them meaning, purpose, and joy. Labeling a particular medication \u201cmiraculous\u201d creates a risk of over-focusing on one approach even when others are also valuable. On the other hand, clozapine does appear to have a higher level of treatment effectiveness than any other medication for schizophrenia and can be uniquely effective in cases where other medications have failed. The average patient will have spent several years dealing with inadequately effective medications before she or he is offered clozapine. To someone who has struggled with symptoms for so long, finally being on a truly effective medication certainly can feel miraculous.<\/p>\n<\/div>

\u95ee\uff1a\u4e3a\u4ec0\u4e48\u6709\u4e9b\u533b\u751f\u548c\u7cbe\u795e\u79d1\u6267\u4e1a\u62a4\u58eb\u5728\u5f00\u6c2f\u6c2e\u5e73\u65b9\u9762\u7ecf\u9a8c\u4e0d\u8db3\uff1f<\/h1><\/div>

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\u7b2c\u56db\u90e8\u5206\u4e4b\u4e09<\/h1><\/div>

\u95ee\uff1a\u60a8\u8ba4\u4e3a\u4ec0\u4e48\u4f7f\u6c2f\u6c2e\u5e73\u5728\u5176\u4ed6\u836f\u7269\u65e0\u6548\u7684\u60c5\u51b5\u4e0b\u6709\u6548\uff1f<\/h1><\/div>

Not all schizophrenias are alike. Understanding that there are different kinds of schizophrenia helps to explain why clozapine appears uniquely effective. Most schizophrenias should probably be renamed “dopamine psychosis”. Scientists have shown that many people with schizophrenia have unusually high dopamine signals in key brain circuits. These findings explain why antipsychotic medications are effective. Most all of them are designed to adjust the elevated dopamine signals.<\/p>\n

About two thirds of people with schizophrenia will have one of these high-dopamine forms of illness and will find relief from dopamine-adjusting medications. But there are other forms of schizophrenia where the dopamine signal appears entirely normal. A variety of neurochemical studies, including some recent PET scan work, has shown that people with these normal-dopamine schizophrenias don’t get much symptom relief from the first-line, dopamine-adjusting schizophrenia medications. This makes sense. Why would we expect that dopamine-focused medications would benefit someone without a high-dopamine brain? “Treatment-resistant schizophrenia” is the name that the field has sort of settled on to refer to the forms of schizophrenia that don’t respond to non-clozapine medications. This label is unfortunate, in my opinion, because it is both discouraging and misleading. The majority of so-called treatment-resistant cases actually respond beautifully to clozapine. It’s not that these illnesses were resistant to treatment. It’s that these folks have a normal-dopamine form of schizophrenia that won’t be served by dopamine-adjusting meds. Clozapine works in the majority of these schizophrenias because clozapine is not a dopamine-adjusting medication. Clozapine is the only thing we know of that works well for normal-dopamine schizophrenia.<\/p>\n<\/div>

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\u7b2c\u56db\u90e8\u5206\uff08\u5171\u56db\u90e8\u5206\uff09<\/h1><\/div>

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Don’t delay. The research is clear: the longer someone experiences psychosis, the lower their prospects for long-term recovery. So, getting someone into remission as soon as possible is one of the most important goals in the care of individuals suffering from acute psychosis. Patients with recent-onset schizophrenia should go into remission (or be well on their way to remission) within no more than 8 months of treatment with antipsychotic medication (up to four months with medication #1, and up to four months with medication #2 if medication #1 failed to work). If delusions or hallucinations are not controlled by two different antipsychotic medications, the likelihood that the patient will respond to a third medication is minuscule, unless that medication is clozapine \u2013 where the response rate is more than 50%. Delaying the initiation of clozapine is equivalent to prolonging the duration of psychosis. And prolonged duration of psychosis has been shown to reduce quality of life in both the short-term and long-term.<\/p>\n<\/div>

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<\/div><\/div>\n<\/p>","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":2240,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-2491","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"\nMessamore Clozapine Question and Answer - CURESZ Foundation<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/curesz.org\/zh\/messamore-clozapine-question-and-answer\/\" \/>\n<meta property=\"og:locale\" content=\"zh_CN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Messamore Clozapine Question and Answer - CURESZ Foundation\" \/>\n<meta property=\"og:url\" content=\"https:\/\/curesz.org\/zh\/messamore-clozapine-question-and-answer\/\" \/>\n<meta property=\"og:site_name\" content=\"CURESZ Foundation\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Cureszorg\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-28T13:09:24+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/curesz.org\/wp-content\/uploads\/2019\/07\/messamore-picture.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"200\" \/>\n\t<meta property=\"og:image:height\" content=\"212\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@cureszorg\" \/>\n<meta name=\"twitter:label1\" content=\"\u9884\u8ba1\u9605\u8bfb\u65f6\u95f4\" \/>\n\t<meta name=\"twitter:data1\" content=\"14 \u5206\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/curesz.org\\\/messamore-clozapine-question-and-answer\\\/\",\"url\":\"https:\\\/\\\/curesz.org\\\/messamore-clozapine-question-and-answer\\\/\",\"name\":\"Messamore Clozapine Question and Answer - 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