在抑郁症治疗中，何时联用抗抑郁药才合适？
When is antidepressant polypharmacy appropriate in the treatment of depression?
作者信息
Si Tianmei, Wang Ping
机构信息
Beijing Shijitan Hospital, Capital University of Medical Sciences, Beijing, China.
出版信息
Shanghai Arch Psychiatry. 2014 Dec;26(6):357-9. doi: 10.11919/j.issn.1002-0829.214152.
Depression is a serious medical condition that is often only partially improved or completely unchanged after standard treatment with antidepressant medications. Various approaches have been developed to treat this subgroup of individuals with 'treatment-resistant' depression; but many individuals continue to live with chronic depressive symptoms that seriously affect their quality of life and overall functioning. One relatively new strategy is 'antidepressant polypharmacy' - simultaneously administering two or more antidepressant medications. Given the heterogeneity of the etiology of depression, this approach could improve therapeutic outcomes by concurrently activating multiple neurological pathways with different mechanisms of action, but there is also the risk that using multiple antidepressants would increase the prevalence and severity of side effects. Further work is needed to assess the potential benefits and risks of this strategy to managing treatmentresistant depression.
抑郁症是一种严重的医学病症，在使用抗抑郁药物进行标准治疗后，病情往往仅得到部分改善或完全没有变化。人们已经开发出各种方法来治疗这一患有“难治性”抑郁症的亚组患者；但许多人仍长期受抑郁症状困扰，这些症状严重影响他们的生活质量和整体功能。一种相对较新的策略是“抗抑郁药联合治疗”——同时服用两种或更多种抗抑郁药物。鉴于抑郁症病因的异质性，这种方法可以通过同时激活多种具有不同作用机制的神经通路来改善治疗效果，但同时使用多种抗抑郁药也有增加副作用发生率和严重程度的风险。需要进一步开展工作来评估这种治疗难治性抑郁症策略的潜在益处和风险。
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