Bielski R J, Friedel R O
West J Med. 1977 May;126(5):347-52.
Depression is both a common and a greatly undertreated illness in the United States today. The focus of this review is a definition of the characteristics of four subtypes of depression which appear to be differentially sensitive to four different classes of medications. The tricyclic antidepressants should be used for patients with unipolar depression and vegetative symptoms. Lithium appears to be most effective for bipolar depressives. The monoamine oxidase (MAO) inhibitors are best used for patients with atypical depression. Antipsychotic medications appear to be useful for depressed patients with psychotic symptoms or agitation. Recent pharmacokinetic and biochemical data, including serum lithium levels, plasma tricyclic levels, and the predictive ability of pretreatment urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) levels are also reviewed.
抑郁症在当今美国既是一种常见疾病，也是一种治疗严重不足的疾病。本综述的重点是对抑郁症四种亚型的特征进行定义，这四种亚型似乎对四类不同药物的敏感性有所差异。三环类抗抑郁药应用于患有单相抑郁症及植物神经症状的患者。锂盐对双相抑郁症患者似乎最为有效。单胺氧化酶（MAO）抑制剂最适用于非典型抑郁症患者。抗精神病药物对伴有精神病症状或激越的抑郁症患者似乎有用。本文还综述了近期的药代动力学和生化数据，包括血清锂水平、血浆三环类药物水平，以及治疗前尿中3-甲氧基-4-羟基苯乙二醇（MHPG）水平的预测能力。
