Department of Psychiatry, Penn State College of Medicine, Hershey, Pennsylvania, USA.
J Clin Psychiatry. 2010 Jul;71(7):e15. doi: 10.4088/JCP.9078tx1c.
A variety of American and European guidelines are available for clinicians treating major depressive disorder and depressive subtypes. Major Western guidelines published since 2000 make similar recommendations for all stages of treatment for depression, including a reliance on measurement-based care. First-line treatment is usually a serotonin reuptake inhibitor, psychotherapy, or a combination of pharmacotherapy and psychotherapy. Next-step treatment recommendations are switching or augmentation, depending on patient response to the initial treatment. Maintenance therapy continues the approach that led to remission. The American Psychiatric Association will release a new treatment guideline to offer information on developments made since the last guidelines were published in 2000. Despite progress made during the last decade, no major breakthroughs in the treatment of depression have occurred, and genetic testing developments allowing for personalized care remain the goal of research.
各种美国和欧洲的指南都可供治疗重度抑郁症和抑郁亚型的临床医生使用。自 2000 年以来发布的主要西方指南为抑郁症治疗的所有阶段提出了类似的建议，包括依赖基于测量的护理。一线治疗通常是选择性 5-羟色胺再摄取抑制剂、心理治疗或药物治疗和心理治疗的结合。根据患者对初始治疗的反应，下一步治疗建议是换药或增效。维持治疗继续采用导致缓解的方法。美国精神病学协会将发布新的治疗指南，提供自 2000 年上次指南发布以来的进展信息。尽管在过去十年中取得了进展，但在抑郁症治疗方面没有取得重大突破，允许个性化护理的基因检测发展仍然是研究的目标。
