外来でSSRIを出す時に不安がよぎります。
・Mirtazapine is an atypical antidepressant that can be used to treat patients with depression, particularly those with symptoms of weight loss or sleeplessness.
ミルタザピンは抗不安薬。SSRI併用でもセロトニン症候群はおこしにくい。
・Bupropion inhibits the norepinephrine transporter and the dopamine transporter with minimal effect on serotonergic activity.
ブプロピオンはノルアド・ドパミン再取り込み阻害(NDRI)。抗うつ薬。
・MAOIs used in combination with SSRIs or TCAs can lead to a serious adverse effect called serotonin syndrome. It is characterized by fever, myoclonus, tremor, hyperreflexia, and mental status changes. An SSRI or TCA should be discontinued at least 14 days prior to starting an MAOI, and vice versa.
MAOIとSSRIやTCAの併用でセロトニン症候群を引き起こす。
MAO is responsible for breaking down neurotransmitters.
MAOは神経伝達物質の分解作用あり。MAOは2種類。
(1) MAO-A, which breaks down tyramine, serotonin, norepinephrine, and dopamine
(2) MAO-B, which primarily breaks down dopamine.
Tranylcypromine is an MAO-A inhibitor.
MAO-A阻害薬でセロトニンやドーパミンの分解を阻止し、濃度保つ。
・Wernicke encephalopathy manifests with the classic triad of confusion, ophthalmoplegia, and ataxia.
・Korsakoff psychosis (personality change, confabulation, and memory loss) is a late manifestation of Wernicke encephalopathy and is often irreversible.
ウェルニッケ脳症の三徴:意識障害、外眼筋麻痺、小脳失調
ビタミンB1欠乏による。
コルサコフ症候群になると人格変化、健忘に対して作話。不可逆的。
視床背内側核または両側乳頭体の障害による。
・Atrophy of the caudate nucleus is seen in patients with Huntington disease, which may manifest with sudden jerking movements (chorea) progressing over time.
尾状核の萎縮性→ハンチントン
・Depigmentation within the substantia nigra pars compacta is associated with Parkinson disease, which is characterized by a resting tremor, shuffling gait, and slow movements (bradykinesia).
黒色緻密部変性→パーキンソン病。
ドパミン減少。
・パーキンソン症候群：薬剤性、外傷性、脳血管障害、中毒（一酸化炭素）が原因。
・Lesions of the subthalamic nucleus may cause hemiballismus, which manifests as a unilateral wild flailing of the extremities.
視床下核の障害→片側バリズム(責任病巣は対側の視床下核)
・Neurofibrillary tangles and widening of the ventricles are associated with Alzheimer disease (AD). Patients with AD experience memory loss, but do not demonstrate any obvious physical findings (such as abdominal distention or skin changes).
神経原線維変化→アルツハイマー
・Listeria is an intracellular gram-positive anaerobe capable of inducing actin polymerization
リステリアは細胞内寄生嫌気グラム陽性菌でアクチンポリメライゼーションを誘導！
