Ferrando Stephen J, Freyberg Zachary
Department of Psychiatry, The New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, USA.
Int Rev Psychiatry. 2008 Feb;20(1):61-71. doi: 10.1080/09540260701862060.
The primary goal of this paper is to provide a critical review of the literature on treatment of depression in HIV/AIDS. There is a substantial research literature documenting the efficacy of conventional antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), novel agents such as dehydroepiandrosterone, psychostimulants and some psychotherapies, particularly interpersonal and group psychotherapy for the treatment of depression in HIV. However, lack of comparative studies makes it difficult to draw a firm consensus regarding the best course of treatment. In devising a treatment plan, clinicians should take into account stage of HIV illness, co-morbid illnesses such as Hepatitis B and C, the potential for drug interactions with antiretroviral and other medications used to treat HIV and patient preference.
本文的主要目标是对关于HIV/AIDS患者抑郁症治疗的文献进行批判性综述。有大量研究文献记录了传统抗抑郁药的疗效,特别是选择性5-羟色胺再摄取抑制剂(SSRI)、诸如脱氢表雄酮之类的新型药物、精神兴奋剂以及一些心理疗法,尤其是人际心理治疗和团体心理治疗对HIV患者抑郁症的治疗效果。然而,由于缺乏比较性研究,难以就最佳治疗方案达成确凿的共识。在制定治疗计划时,临床医生应考虑HIV疾病的阶段、诸如乙型和丙型肝炎之类的共病、与抗逆转录病毒药物及用于治疗HIV的其他药物发生药物相互作用的可能性以及患者的偏好。