Hospital Garcia de Orta, Almada, Portugal.
Clin Drug Investig. 2011 Oct 19;31 Suppl 1:19-24. doi: 10.2165/1159617-S0-000000000-00000.
Major depressive disorder (MDD) is one of the most common mental disorders, with a lifetime prevalence of approximately 13% in Europe. Although the primary symptom of MDD is depressed mood and a loss of interest or pleasure in everyday life, patients with MDD often present with a variety of other symptoms, such as sleep disturbances, fatigue, anxiety and somatic complaints. Antidepressant drugs are frequently used as first-line therapy for MDD. Bupropion is a second-generation antidepressant drug that inhibits reuptake of the neurotransmitters dopamine and norepinephrine, and has no direct serotonergic effects, a unique property among antidepressants. This article highlights the use of bupropion in the treatment of three patients with varying presentations of MDD, including as combination therapy in a patient refractory to treatment with a selective serotonin reuptake inhibitor, monotherapy in a patient with somatic symptoms of depression and loss of libido, and in a patient complaining of anxiety as a symptom of MDD. Bupropion treatment was successful in all patients, resulting in remission of symptoms and the patients returning to their normal lives.
重度抑郁症(MDD)是最常见的精神障碍之一,在欧洲的终身患病率约为 13%。尽管 MDD 的主要症状是情绪低落和对日常生活失去兴趣或乐趣,但 MDD 患者常伴有多种其他症状,如睡眠障碍、疲劳、焦虑和躯体抱怨。抗抑郁药常被用作 MDD 的一线治疗药物。安非他酮是一种第二代抗抑郁药,可抑制神经递质多巴胺和去甲肾上腺素的再摄取,且没有直接的 5-羟色胺能作用,这是抗抑郁药中的一个独特特性。本文重点介绍了安非他酮在治疗 3 例表现不同的 MDD 患者中的应用,包括作为一种对选择性 5-羟色胺再摄取抑制剂治疗反应不佳的患者的联合治疗、对伴有躯体症状和性欲丧失的抑郁患者的单一疗法,以及对作为 MDD 症状的焦虑患者的治疗。安非他酮治疗在所有患者中均取得成功,症状缓解,患者恢复正常生活。