文化与健康课件(6226KB).pptVIP

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文化与健康课件(6226KB).ppt

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课堂讨论作业 1。我的“文化休克”体验 2。我们家里的代沟 3。我与少数民族、外国人打交道的经历 4。我经历过的文化偏见 5。对前述案例的文化学思考 * KEY POINTS Addition of SSRI to ongoing (ineffective) therapy (mostly TCAs) resulted in a 80% response.1 Concomitant therapy with an SSRI and NRI resulted in a rapid, robust response.2 Treatment-resistant patients responded to concomitant therapy with an SRI and NRI, with or without concurrent lithium therapy.3 Higher remission rates were observed with venlafaxine (SNRI) compared with SSRIs.4 Remission rates with duloxetine (SNRI) and fluoxetine (SSRI) were 56% and 30%, respectively.5 Remission rates with duloxetine vs paroxetine (SSRI) were 57% and 34%, respectively (p0.022).6 BACKGROUND In a double-blind clinical trial of duloxetine (n=70) vs placebo (n=70) or fluoxetine (n=33) for the treatment of MDD, duloxetine was superior to placebo with regard to the primary outcome measure of change in HAMD17 (p=0.009) and most secondary outcome measures. Estimated probabilities of response and remission were 64% and 56%, respectively, for duloxetine, compared with 52% and 30% for fluoxetine, and 48% and 32% for placebo. In general, duloxetine was well tolerated.5 In another double-blind clinical trial of duloxetine 40 mg/day (n=55), duloxetine 80 mg/day (n=53), placebo (n=52), and fluoxetine (n=49) for the treatment of MDD, duloxetine 40 mg/day and 80 mg/day were superior to placebo with regard to mean total change in HAMD17 (p=0.002 and p0.034, respectively), while paroxetine was not. Duloxetine 80 mg/day was superior to placebo for most other measures and was superior to paroxetine on HAMD17 improvement (p=0.037) and estimated probability of remission (57% for duloxetine 80 mg/day, 34% for paroxetine; p=0.022). The only adverse event reported significantly more frequently for duloxetine 80 mg/day, than for paroxetine, wasinsomnia (p=0.031).6 REFERENCES Weilburg JB, et al. Fluoxetine added to non-MAOI antidepressants converts nonresponders to responders: A preliminary report. J Clin Ps