Mathys Monica, Mitchell Brian G
Texas Tech University Health Sciences Center School of Pharmacy, Dallas, TX 75216, USA.
J Pharm Pract. 2011 Dec;24(6):520-33. doi: 10.1177/0897190011426972. Epub 2011 Nov 17.
Only 50% of depressed patients achieve remission of symptoms after 2 trials of antidepressants. Therefore one half of patients are considered treatment resistant. Studies have shown that with each failed antidepressant, chances of remission continue to decline. Untreated depressive symptoms lead to impaired social and occupational function, decline of physical health, suicidal thoughts, and increased health care utilization. Clinicians recognize there is an urgent need to find an efficacious treatment, but it becomes more difficult to decide on an appropriate therapy once a patient has failed 2 to 3 trials of antidepressants. An evidence-based review was performed to assess the efficacy and safety of several different antidepressant strategies to help the clinician decide which may be beneficial for specific patients.
仅50%的抑郁症患者在进行两轮抗抑郁药治疗后症状得到缓解。因此，有一半的患者被认为是难治性的。研究表明，每一次抗抑郁药治疗失败，症状缓解的几率都会持续下降。未经治疗的抑郁症状会导致社交和职业功能受损、身体健康下降、出现自杀念头以及医疗保健利用率增加。临床医生认识到迫切需要找到一种有效的治疗方法，但一旦患者在两到三轮抗抑郁药治疗中失败，就更难决定合适的治疗方案。为此进行了一项循证综述，以评估几种不同抗抑郁策略的疗效和安全性，帮助临床医生确定哪种策略可能对特定患者有益。
