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使用抗抑郁药治疗抑郁症的循证指南:2008年英国精神药理学会指南的修订版

Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 British Association for Psychopharmacology guidelines.

作者信息

Cleare Anthony, Pariante C M, Young A H, Anderson I M, Christmas D, Cowen P J, Dickens C, Ferrier I N, Geddes J, Gilbody S, Haddad P M, Katona C, Lewis G, Malizia A, McAllister-Williams R H, Ramchandani P, Scott J, Taylor D, Uher R

机构信息

Professor of Psychopharmacology & Affective Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, UK

Professor of Biological Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, UK.

出版信息

J Psychopharmacol. 2015 May;29(5):459-525. doi: 10.1177/0269881115581093. Epub 2015 May 12.

Abstract

A revision of the 2008 British Association for Psychopharmacology evidence-based guidelines for treating depressive disorders with antidepressants was undertaken in order to incorporate new evidence and to update the recommendations where appropriate. A consensus meeting involving experts in depressive disorders and their management was held in September 2012. Key areas in treating depression were reviewed and the strength of evidence and clinical implications were considered. The guidelines were then revised after extensive feedback from participants and interested parties. A literature review is provided which identifies the quality of evidence upon which the recommendations are made. These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse and stopping treatment. Significant changes since the last guidelines were published in 2008 include the availability of new antidepressant treatment options, improved evidence supporting certain augmentation strategies (drug and non-drug), management of potential long-term side effects, updated guidance for prescribing in elderly and adolescent populations and updated guidance for optimal prescribing. Suggestions for future research priorities are also made.

摘要

对2008年英国精神药理学会关于使用抗抑郁药治疗抑郁症的循证指南进行了修订,以便纳入新证据并在适当时更新建议。2012年9月召开了一次由抑郁症及其管理方面的专家参加的共识会议。对抑郁症治疗的关键领域进行了审查,并考虑了证据强度和临床意义。然后,在参与者和相关方提供大量反馈后,对指南进行了修订。提供了一篇文献综述,确定了提出这些建议所依据的证据质量。这些指南涵盖抑郁症的性质和检测、抗抑郁药的急性治疗、药物与替代治疗的选择、处方和管理中的实际问题、下一步治疗、预防复发、复发治疗和停止治疗。自上次2008年指南发布以来的重大变化包括有了新的抗抑郁治疗选择、支持某些增效策略(药物和非药物)的证据有所改善、潜在长期副作用的管理、针对老年和青少年人群处方的更新指南以及最佳处方的更新指南。还提出了对未来研究重点的建议。

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