抗抑郁药难治性抑郁症及抗抑郁药相关的自杀行为：潜在双相情感障碍的作用
Antidepressant-resistant depression and antidepressant-associated suicidal behaviour: the role of underlying bipolarity.
作者信息
Rihmer Zoltan, Gonda Xenia
机构信息
Department of Clinical and Theoretical Mental Health, Kútvölgyi Clinical Center, Semmelweis University, Kútvölgyi út 4., 1125 Budapest, Hungary.
出版信息
Depress Res Treat. 2011;2011:906462. doi: 10.1155/2011/906462. Epub 2011 Apr 3.
Abstract
The complex relationship between the use of antidepressants and suicidal behaviour is one of the hottest topics of our contemporary psychiatry. Based on the literature, this paper summarizes the author's view on antidepressant-resistant depression and antidepressant-associated suicidal behaviour. Antidepressant-resistance, antidepressant-induced worsening of depression, antidepressant-associated (hypo)manic switches, mixed depressive episode, and antidepressant-associated suicidality among depressed patients are relatively most frequent in bipolar/bipolar spectrum depression and in children and adolescents. As early age at onset of major depressive episode and mixed depression are powerful clinical markers of bipolarity and the manic component of bipolar disorder (and possible its biological background) shows a declining tendency with age antidepressant-resistance/worsening, antidepressant-induced (hypo)manic switches and "suicide-inducing" potential of antidepressants seem to be related to the underlying bipolarity.
摘要
抗抑郁药的使用与自杀行为之间的复杂关系是当代精神病学中最热门的话题之一。基于文献，本文总结了作者对抗抑郁药难治性抑郁症和抗抑郁药相关自杀行为的观点。在双相情感障碍/双相谱系障碍患者以及儿童和青少年中，抗抑郁药难治性、抗抑郁药导致的抑郁恶化、抗抑郁药相关的（轻）躁狂发作、混合性抑郁发作以及抑郁症患者中抗抑郁药相关的自杀倾向相对最为常见。由于重度抑郁发作和混合性抑郁的发病年龄较早是双相情感障碍的有力临床标志，且双相情感障碍的躁狂成分（以及可能的生物学背景）随年龄呈下降趋势，因此抗抑郁药难治性/恶化、抗抑郁药诱发的（轻）躁狂发作以及抗抑郁药的“自杀诱导”潜力似乎与潜在的双相情感障碍有关。
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