Holtzheimer Paul E
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.
Focus (Am Psychiatr Publ). 2010 Fall;8(4):488-500. doi: 10.1176/foc.8.4.foc488.
Treatment-resistant depression (TRD) is a prevalent, disabling, and costly condition affecting 1%-4% of the U.S.
Current approaches to managing TRD include medication augmentation (with lithium, thyroid hormone, buspirone, atypical antipsychotics, or various antidepressant medications), psychotherapy, and ECT. Advances in understanding the neurobiology of mood regulation and depression have led to a number of new potential approaches to managing TRD, including medications with novel mechanisms of action and focal brain stimulation techniques. This review will define and discuss the epidemiology of TRD, review the current approaches to its management, and then provide an overview of several developing interventions.
难治性抑郁症（TRD）是一种普遍存在、使人致残且成本高昂的疾病，影响着1% - 4%的美国人口。
目前管理TRD的方法包括药物增效（使用锂盐、甲状腺激素、丁螺环酮、非典型抗精神病药物或各种抗抑郁药物）、心理治疗和电休克治疗（ECT）。在理解情绪调节和抑郁症的神经生物学方面取得的进展已带来了一些管理TRD的新潜在方法，包括具有新作用机制的药物和局部脑刺激技术。本综述将定义并讨论TRD的流行病学，回顾其当前的管理方法，然后概述几种正在发展的干预措施。
