Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia Veterans Affairs Medical Center, and Pittsburgh Medical Center, Philadelphia and Pittsburgh, USA.
J Clin Psychiatry. 2009 Nov;70(11):e42. doi: 10.4088/JCP.8001cc15c.
Patients who do not respond to initial antidepressant treatment are more difficult to treat and have lower odds of remission than those who fully or partially respond to initial pharmacotherapy. Potential treatment options for nonresponders include combination and switching strategies, both of which can be done within a single class of medications or across medication classes. Choosing the correct strategy and appropriate pharmaceutical option or options requires consideration of not only algorithm recommendations, but also a variety of variables including, but not limited to, the patient's symptom and side effect profiles.
对于初始抗抑郁治疗无反应的患者,其治疗难度更大,缓解的可能性也低于初始药物治疗完全或部分有效的患者。对于无反应者的潜在治疗选择包括联合和转换策略,这两种策略都可以在同一类药物中进行,也可以跨药物类别进行。选择正确的策略和适当的药物选择或选择需要考虑不仅算法推荐,还包括各种变量,包括但不限于患者的症状和副作用谱。