Department of Psychiatry, Chang Gung Memorial Hospital at Linko and College of Medicine, Chang Gung University, Gweisan Township, 333, Taoyuan County, Taiwan, Republic of China.
CNS Drugs. 2013 May;27 Suppl 1:S21-7. doi: 10.1007/s40263-012-0030-1.
Failure to achieve an adequate response after initial antidepressant treatment in patients with depression is common and remains a clinical challenge. In recent years, some atypical antipsychotic agents have been approved by the US Food and Drug Administration for use in an augmentation strategy for major depressive disorder, and other agents are already in common use in clinical practice. We conducted a search of MEDLINE for relevant studies of augmentation strategies using randomized controlled trials and meta-analyses, and we summarize and discuss the various agents other than atypical antipsychotics. Lithium and thyroid hormone augmentation may improve the response of tricyclic antidepressants but not that of selective serotonin reuptake inhibitors. The efficacy of augmentation with modafinil, buspirone, methylphenidate, folic acid, pindolol and lamotrigine is limited or equivocal. Most of the studies have not focused on treatment-resistant depression (TRD). More trials are needed to help develop evidence-based options for augmentation in TRD.
在抑郁症患者接受初始抗抑郁治疗后未能获得充分应答的情况较为常见，仍然是临床面临的挑战。近年来，一些非典型抗精神病药物已获得美国食品药品监督管理局批准，用于重度抑郁症的增效治疗，其他药物也已在临床实践中广泛应用。我们对使用随机对照试验和荟萃分析的增效策略相关研究进行了 MEDLINE 检索，并对除非典型抗精神病药物以外的各种药物进行了总结和讨论。锂盐和甲状腺激素增效可能会改善三环类抗抑郁药的应答，但不会改善选择性 5-羟色胺再摄取抑制剂的应答。莫达非尼、丁螺环酮、哌甲酯、叶酸、普萘洛尔和拉莫三嗪增效的疗效有限或不确定。大多数研究并未关注治疗抵抗性抑郁症（TRD）。需要更多的试验来帮助开发针对 TRD 的增效治疗的循证选择。
