Anderson Ian M
Manchester Academic Health Science Centre, University of Manchester, UK.
Curr Top Behav Neurosci. 2013;14:263-89. doi: 10.1007/7854_2012_208.
Antidepressants were first developed serendipitously 60 years ago and gave rise to the monoamine hypothesis of depression and antidepressant action which has persisted in various forms ever since. Although we have made huge strides in our understanding of the pharmacology of antidepressants, and in the neuroscience of depression, our current antidepressants have changed little since the original drugs. In this chapter I first review some controversies in the use of antidepressant drugs including whether they actually work, and then go on to describe the current state of our clinical use of antidepressants, looking both at the principles and practice of treatment and reviewing the evidence for efficacy, tolerability and safety in acute and sequenced treatments. I finally briefly consider future directions and the aspiration of developing more effective antidepressants.
60年前，抗抑郁药首次意外问世，引发了抑郁症和抗抑郁作用的单胺假说，此后该假说一直以各种形式存在。尽管我们在理解抗抑郁药的药理学以及抑郁症的神经科学方面取得了巨大进展，但自最初的药物以来，我们目前使用的抗抑郁药几乎没有变化。在本章中，我首先回顾抗抑郁药使用中的一些争议，包括它们是否真的有效，然后继续描述我们目前抗抑郁药的临床使用状况，审视治疗的原则和实践，并回顾急性和序贯治疗中疗效、耐受性和安全性的证据。最后，我简要思考未来的方向以及开发更有效抗抑郁药的愿望。
