Leiderman Eduardo A, Nemirovsky Martín, Elenitza Irene, Jufe Gabriela, Levin Santiago, Mazaira Silvina, Mussa Alexis, Wikinski Silvia
1ra Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Piso 15, CP 1113, Buenos Aires, Argentina.
Vertex. 2007 Sep-Oct;18(75):335-43.
The objective of this study was to examine the prescribing practices of Argentinean psychiatrists in the treatment of major depression and to observe similarities and/or differences with some consensus or treatment guidelines.
Four hundred two psychiatrists were surveyed during a specialty meeting in October 2005.
A total of 88.2 % of psychiatrists surveyed considered that every depressed patient must be treated with medication. The most prescribed antidepressants for outpatients were paroxetine, sertraline and fluoxetine. Venlafaxine was included for inpatients. The majority of psychiatrists indicated antidepressant therapy lasting from 12 to 24 months after remission of the first depressive episode. Antidepressant dosages remained unchanged during that period. A low percentage had used lithium or thyroid hormones as augmentation medications, the addition of other antidepressant being the most used augmentation strategy. The most prescribed antidepressant combination was dual antidepressants and SSRIs. Prescribing practices differed according to personal factors of the physicians.
Discrepancies between clinical practice and treatment guidelines were observed. Further research over the underlying causes of these discrepancies and mechanisms to reduce them are necessary.
本研究的目的是调查阿根廷精神科医生治疗重度抑郁症的处方习惯，并观察其与某些共识或治疗指南的异同。
2005年10月在一次专业会议期间对402名精神科医生进行了调查。
共有88.2%的接受调查的精神科医生认为，每位抑郁症患者都必须接受药物治疗。门诊患者最常使用的抗抑郁药是帕罗西汀、舍曲林和氟西汀。文拉法辛用于住院患者。大多数精神科医生表示，首次抑郁发作缓解后，抗抑郁治疗持续12至24个月。在此期间，抗抑郁药剂量保持不变。使用锂盐或甲状腺激素作为增效药物的比例较低，添加其他抗抑郁药是最常用的增效策略。最常开具的抗抑郁药组合是双重抗抑郁药和选择性5-羟色胺再摄取抑制剂（SSRI）。处方习惯因医生的个人因素而异。
观察到临床实践与治疗指南之间存在差异。有必要对这些差异的潜在原因及减少差异的机制进行进一步研究。
