老年重度抑郁症药物治疗的系统方法。
A systematic approach to pharmacotherapy for geriatric major depression.
作者信息
Mulsant Benoit H, Blumberger Daniel M, Ismail Zahinoor, Rabheru Kiran, Rapoport Mark J
机构信息
Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, Ontario M6J 1H4, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada.
Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, Ontario M6J 1H4, Canada.
出版信息
Clin Geriatr Med. 2014 Aug;30(3):517-34. doi: 10.1016/j.cger.2014.05.002. Epub 2014 Jun 14.
Abstract
The broadening use of antidepressants among older Americans has not been associated with a notable decrease in the burden of geriatric depression. This article, based on a selective review of the literature, explores several explanations for this paradox. The authors propose that the effectiveness of antidepressants depends in large part on the way they are used. Evidence supports that antidepressant pharmacotherapy leads to better outcomes when guided by a treatment algorithm as opposed to attempting to individualize treatment. Several published guidelines and pharmacotherapy algorithms developed for the treatment of geriatric depression are reviewed, and an updated algorithm proposed.
摘要
在美国老年人中，抗抑郁药使用范围的扩大与老年抑郁症负担的显著降低并无关联。本文基于对文献的选择性回顾，探讨了这一矛盾现象的几种解释。作者提出，抗抑郁药的有效性在很大程度上取决于其使用方式。有证据支持，与试图进行个体化治疗相比，在治疗算法的指导下进行抗抑郁药物治疗会带来更好的效果。本文回顾了为治疗老年抑郁症而制定的若干已发表指南和药物治疗算法，并提出了一种更新的算法。
相似文献
1
A systematic approach to pharmacotherapy for geriatric major depression.老年重度抑郁症药物治疗的系统方法。
Clin Geriatr Med. 2014 Aug;30(3):517-34. doi: 10.1016/j.cger.2014.05.002. Epub 2014 Jun 14.
2
Algorithms in clinical psychiatry: a stepped approach toward the path to recovery.临床精神病学中的算法：通往康复之路的逐步方法。
Psychopharmacol Bull. 2002 Summer;36 Suppl 2:142-9.
3
Major depressive disorder treatment guidelines in China.中国重度抑郁症治疗指南。
J Clin Psychiatry. 2010;71 Suppl E1:e06. doi: 10.4088/JCP.9058se1c.06gry.
4
Pharmacotherapy for late-life depression.老年期抑郁症的药物治疗。
J Clin Psychiatry. 2011 Jan;72(1):e04. doi: 10.4088/JCP.7085tx2cj.
5
Algorithms For Treatment of Major Depressive Disorder: Efficacy and Cost-Effectiveness.治疗重度抑郁症的算法：疗效和成本效益。
Pharmacopsychiatry. 2019 Mar;52(3):117-125. doi: 10.1055/a-0643-4830. Epub 2018 Jul 9.
6
An algorithm for the pharmacological treatment of depression.抑郁症的药理学治疗算法。
Acta Psychiatr Scand. 2010 Mar;121(3):180-9. doi: 10.1111/j.1600-0447.2009.01492.x. Epub 2009 Oct 30.
7
Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments.加拿大情绪与焦虑治疗网络（CANMAT）2016年成人重度抑郁症管理临床指南：第3节. 药物治疗。
Can J Psychiatry. 2016 Sep;61(9):540-60. doi: 10.1177/0706743716659417. Epub 2016 Aug 2.
8
If at first you don't succeed: a review of the evidence for antidepressant augmentation, combination and switching strategies.如果一开始不成功：抗抑郁药增效、联合和转换策略的证据回顾。
Drugs. 2011 Jan 1;71(1):43-64. doi: 10.2165/11587620-000000000-00000.
9
Combination therapy with monoamine oxidase inhibitors and other antidepressants or stimulants: strategies for the management of treatment-resistant depression.单胺氧化酶抑制剂与其他抗抑郁药或兴奋剂的联合治疗：难治性抑郁症的管理策略
Pharmacotherapy. 2015 Apr;35(4):433-49. doi: 10.1002/phar.1576.
10
The symptom cluster-based approach to individualize patient-centered treatment for major depression.基于症状群的方法个体化治疗重度抑郁症患者的以患者为中心的治疗。
J Am Board Fam Med. 2014 Jan-Feb;27(1):151-9. doi: 10.3122/jabfm.2014.01.130145.
引用本文的文献
1
Measurement-Based Care to Enhance Antidepressant Treatment Outcomes in Major Depressive Disorder: A Randomized Clinical Trial.基于测量的护理以改善重度抑郁症的抗抑郁治疗效果：一项随机临床试验。
JAMA Netw Open. 2025 Sep 2;8(9):e2529427. doi: 10.1001/jamanetworkopen.2025.29427.
2
Exploring the Complex Relationship Between Antidepressants, Depression and Neurocognitive Disorders.探索抗抑郁药、抑郁症与神经认知障碍之间的复杂关系。
Biomedicines. 2024 Nov 30;12(12):2747. doi: 10.3390/biomedicines12122747.
3
Association Between Prehip Fracture Antidepressant Use and Posthip Fracture Length of Hospital Stay in Medicare Beneficiaries and Assessing Sex Differences.医疗保险受益人前髋部骨折抗抑郁药使用与髋部骨折后住院时间的关联及性别差异评估
Am J Geriatr Psychiatry. 2025 Jun;33(6):654-663. doi: 10.1016/j.jagp.2024.11.001. Epub 2024 Nov 14.
4
Propofol enhancement of slow wave sleep to target the nexus of geriatric depression and cognitive dysfunction: protocol for a phase I open label trial.丙泊酚增强慢波睡眠以靶向老年抑郁症和认知功能障碍的枢纽：一项 I 期开放标签试验的方案。
BMJ Open. 2024 May 30;14(5):e087516. doi: 10.1136/bmjopen-2024-087516.
5
Research status and global trends of late-life depression from 2004 to 2023: bibliometric analysis.2004年至2023年老年抑郁症的研究现状与全球趋势：文献计量分析
Front Aging Neurosci. 2024 Apr 30;16:1393110. doi: 10.3389/fnagi.2024.1393110. eCollection 2024.
6
Targeting Slow Wave Sleep Deficiency in Late-Life Depression: A Case Series With Propofol.针对老年期抑郁症的慢波睡眠缺失：丙泊酚治疗病例系列
Am J Geriatr Psychiatry. 2023 Aug;31(8):643-652. doi: 10.1016/j.jagp.2023.03.009. Epub 2023 Mar 28.
7
Age as a moderating factor of treatment resistance in depression.年龄是抑郁症治疗抵抗的一个调节因素。
Eur Psychiatry. 2023 Apr 20;66(1):e35. doi: 10.1192/j.eurpsy.2023.17.
8
A Collaborative-Care Telephone-Based Intervention for Depression, Anxiety, and at-Risk Drinking in Primary Care: The PARTNERs Randomized Clinical Trial.基于协作护理的电话干预在初级保健中治疗抑郁、焦虑和处于危险饮酒状态：PARTNERs 随机临床试验。
Can J Psychiatry. 2023 Oct;68(10):732-744. doi: 10.1177/07067437231156243. Epub 2023 Feb 28.
9
Effect of Adjunctive Simvastatin on Depressive Symptoms Among Adults With Treatment-Resistant Depression: A Randomized Clinical Trial.辛伐他汀辅助治疗对治疗抵抗性抑郁症成人抑郁症状的影响：一项随机临床试验。
JAMA Netw Open. 2023 Feb 1;6(2):e230147. doi: 10.1001/jamanetworkopen.2023.0147.
10
Influences of resting-state intrinsic functional brain connectivity on the antidepressant treatment response in late-life depression.静息态功能脑连接对老年期抑郁症抗抑郁治疗反应的影响。
Psychol Med. 2023 Oct;53(13):6261-6270. doi: 10.1017/S0033291722003579. Epub 2022 Dec 9.
本文引用的文献
1
Challenges of the treatment of neuropsychiatric symptoms associated with dementia.痴呆相关神经精神症状的治疗挑战。
Am J Geriatr Psychiatry. 2014 Apr;22(4):317-20. doi: 10.1016/j.jagp.2014.01.008. Epub 2014 Jan 21.
2
Effect of citalopram on agitation in Alzheimer disease: the CitAD randomized clinical trial.西酞普兰对阿尔茨海默病激越的影响：CitAD 随机临床试验。
JAMA. 2014 Feb 19;311(7):682-91. doi: 10.1001/jama.2014.93.
3
National trends in long-term use of antidepressant medications: results from the U.S. National Health and Nutrition Examination Survey.抗抑郁药物长期使用的全国趋势：来自美国国家健康和营养调查的结果。
J Clin Psychiatry. 2014 Feb;75(2):169-77. doi: 10.4088/JCP.13m08443.
4
Acute and long-term treatment of late-life major depressive disorder: duloxetine versus placebo.老年期重度抑郁症的急性和长期治疗：度洛西汀与安慰剂比较。
Am J Geriatr Psychiatry. 2014 Jan;22(1):34-45. doi: 10.1016/j.jagp.2013.01.019. Epub 2013 Feb 6.
5
No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis.抗抑郁药疗效与初始严重程度无关：一项多荟萃分析的结果。
Ann Gen Psychiatry. 2013 Aug 13;12(1):26. doi: 10.1186/1744-859X-12-26.
6
Evaluation of the FDA warning against prescribing citalopram at doses exceeding 40 mg.评估 FDA 关于禁止开超过 40mg 剂量西酞普兰的警告。
Am J Psychiatry. 2013 Jun;170(6):642-50. doi: 10.1176/appi.ajp.2013.12030408.
7
Randomized, double-blind study of the efficacy and tolerability of extended release quetiapine fumarate (quetiapine XR) monotherapy in elderly patients with major depressive disorder.随机、双盲研究富马酸喹硫平缓释片（喹硫平 XR）单药治疗老年抑郁症患者的疗效和耐受性。
Am J Geriatr Psychiatry. 2013 Aug;21(8):769-84. doi: 10.1016/j.jagp.2013.01.010. Epub 2013 Feb 6.
8
Duloxetine versus other anti-depressive agents for depression.度洛西汀与其他抗抑郁药治疗抑郁症的比较
Cochrane Database Syst Rev. 2012 Oct 17;10(10):CD006533. doi: 10.1002/14651858.CD006533.pub2.
9
Validation of a treatment algorithm for major depression in an older Brazilian sample.验证一种适用于巴西老年人群的重度抑郁症治疗算法。
Int J Geriatr Psychiatry. 2013 Jun;28(6):647-53. doi: 10.1002/gps.3876. Epub 2012 Sep 26.
10
Selective serotonin reuptake inhibitors and tricyclic antidepressants in the acute treatment of chronic depression and dysthymia: a systematic review and meta-analysis.选择性 5-羟色胺再摄取抑制剂和三环类抗抑郁药治疗慢性抑郁症和恶劣心境障碍的急性期：系统评价和荟萃分析。
J Affect Disord. 2013 Jan 10;144(1-2):7-15. doi: 10.1016/j.jad.2012.06.007. Epub 2012 Sep 7.
Zotero 插件