Owen R T
Freelance Medical Writer.
Drugs Today (Barc). 2013 Dec;49(12):791-8. doi: 10.1358/dot.2013.49.12.2086138.
The use of two antidepressants from the initiation of treatment in major depressive disorder has been investigated in several recent studies and forms a paradigm shift in the pharmacotherapy of the condition. Several, but not all, trials have claimed improved response and remission rates with the combinations as opposed to monotherapy. The use of folate preparations (folic and folinic acid and l-meth-ylfolate) have shown effective augmentation of antidepressant response in a variety of controlled and open-label settings in patients with normo- and hypofolatemic status. Several recent trials using L-methylfolate, the active and more bioavailable form of folic acid, have shown promising adjunctive use with a well-tolerated adverse event profile.
在近期的多项研究中，对在重度抑郁症治疗起始阶段联合使用两种抗抑郁药物进行了调查，这在该病症的药物治疗中形成了一种范式转变。一些（但并非全部）试验声称，与单一疗法相比，联合用药可提高缓解率和反应率。在正常叶酸水平和低叶酸水平的患者中，在各种对照和开放标签的情况下，使用叶酸制剂（叶酸、亚叶酸和L-甲基叶酸）已显示出可有效增强抗抑郁反应。最近几项使用L-甲基叶酸（叶酸的活性且生物利用度更高的形式）的试验表明，其作为辅助用药前景良好，且不良事件耐受性良好。
