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监测抗抑郁药相关不良反应在治疗重度抑郁症患者中的应用:国际共识声明。

Monitoring for antidepressant-associated adverse events in the treatment of patients with major depressive disorder: An international consensus statement.

机构信息

a School of Medicine, Barwon Health , Deakin University, IMPACT SRC (Innovation in Mental and Physical Health and Clinical Treatment - Strategic Research Centre) , Geelong , Australia.

b Department of Psychiatry , University of Melbourne , Melbourne , Australia.

出版信息

World J Biol Psychiatry. 2018 Aug;19(5):330-348. doi: 10.1080/15622975.2017.1379609. Epub 2017 Oct 6.

Abstract

OBJECTIVES

These recommendations were designed to ensure safety for patients with major depressive disorder (MDD) and to aid monitoring and management of adverse effects during treatment with approved antidepressant medications. The recommendations aim to inform prescribers about both the risks associated with these treatments and approaches for mitigating such risks.

METHODS

Expert contributors were sought internationally by contacting representatives of key stakeholder professional societies in the treatment of MDD (ASBDD, CANMAT, WFSBP and ISAD). The manuscript was drafted through iterative editing to ensure consensus.

RESULTS

Adequate risk assessment prior to commencing pharmacotherapy, and safety monitoring during pharmacotherapy are essential to mitigate adverse events, optimise the benefits of treatment, and detect and assess adverse events when they occur. Risk factors for pharmacotherapy vary with individual patient characteristics and medication regimens. Risk factors for each patient need to be carefully assessed prior to initiating pharmacotherapy, and appropriate individualised treatment choices need to be selected. Some antidepressants are associated with specific safety concerns which were addressed.

CONCLUSIONS

Risks of adverse outcomes with antidepressant treatment can be managed through appropriate assessment and monitoring to improve the risk benefit ratio and improve clinical outcomes.

摘要

目的

这些建议旨在确保患有重度抑郁症(MDD)的患者的安全,并帮助监测和管理在使用已批准的抗抑郁药物治疗期间的不良反应。这些建议旨在告知医生这些治疗方法的相关风险以及减轻这些风险的方法。

方法

通过联系 MDD 治疗的主要利益相关者专业协会(ASBDD、CANMAT、WFSBP 和 ISAD)的代表,在国际范围内寻找专家撰稿人。通过迭代编辑来起草手稿,以确保达成共识。

结果

在开始药物治疗前进行充分的风险评估,以及在药物治疗期间进行安全性监测,对于减轻不良事件、优化治疗效果、以及在发生不良事件时进行检测和评估至关重要。药物治疗的风险因素因个体患者特征和药物治疗方案而异。在开始药物治疗前,需要仔细评估每个患者的风险因素,并选择适当的个体化治疗方案。一些抗抑郁药与特定的安全问题有关,这些问题也得到了处理。

结论

通过适当的评估和监测,可以管理抗抑郁治疗的不良后果风险,以提高风险效益比并改善临床结果。

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