对重度抑郁症的抗抑郁药疗效、有效性、适应症及用法的简要综述。
A brief review of antidepressant efficacy, effectiveness, indications, and usage for major depressive disorder.
作者信息
Nierenberg Andrew A, Ostacher Michael J, Huffman Jeffrey C, Ametrano Rebecca M, Fava Maurizio, Perlis Roy H
机构信息
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
出版信息
J Occup Environ Med. 2008 Apr;50(4):428-36. doi: 10.1097/JOM.0b013e31816b5034.
OBJECTIVE
Antidepressants treat major depressive disorder (MDD) with the burden of associated side effects and difficulties with compliance. The purpose of this article is to review the efficacy and effectiveness of antidepressants for MDD.
METHODS
The authors conducted a focused review of selected key issues and references relevant to the clinically relevant pharmacologic treatment of MDD. Principles of treatment are reviewed. Antidepressants reviewed include SSRIs, mixed norepinephrine or serotonin uptake inhibitors, dopamine or norepinephrine uptake inhibitors, norepinephrine uptake inhibitors, antidepressants with mixed properties, and monoamine oxidase inhibitors. Augmentation and psychotherapy strategies are reviewed.
RESULTS
Antidepressant efficacy has been established in randomized clinical trials and effectiveness studies for acute and long-term treatment, but many patients do not achieve remission. Augmentation strategies and focused psychotherapy can be helpful.
CONCLUSIONS
Antidepressants help most patients with MDD but some are resistant to treatment and have a difficult long-term course.
目的
抗抑郁药治疗重度抑郁症（MDD）时伴有相关副作用负担及依从性困难。本文旨在综述抗抑郁药治疗MDD的疗效和有效性。
方法
作者对与MDD临床相关药物治疗的选定关键问题和参考文献进行了重点综述。回顾了治疗原则。所综述的抗抑郁药包括选择性5-羟色胺再摄取抑制剂（SSRI）、去甲肾上腺素或5-羟色胺混合再摄取抑制剂、多巴胺或去甲肾上腺素再摄取抑制剂、去甲肾上腺素再摄取抑制剂、具有混合特性的抗抑郁药以及单胺氧化酶抑制剂。还综述了增效和心理治疗策略。
结果
抗抑郁药在急性和长期治疗的随机临床试验及有效性研究中已证实其疗效，但许多患者未能实现症状缓解。增效策略和针对性心理治疗可能会有所帮助。
结论
抗抑郁药对大多数MDD患者有帮助，但有些患者对治疗有抵抗性且病程漫长。
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