Saraghi Mana, Golden Leonard R, Hersh Elliot V
Director, Dental Anesthesiology Residency Program, Jacobi Medical Center, Bronx, New York.
Chairman, Department of Anesthesiology, Jacobi Medical Center Bronx, New York.
Anesth Prog. 2017 Winter;64(4):253-261. doi: 10.2344/anpr-64-04-14.
Millions of patients take antidepressant medications in the United States for the treatment of depression or anxiety disorders. Some antidepressants are prescribed off-label to treat problems such as chronic pain, low energy, and menstrual symptoms. Antidepressants are a broad and expansive group of medications, but the more common drug classes include tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors. A miscellaneous or "atypical" category covers other agents. Some herbal supplements that claim to have antidepressant activity will also be discussed. In Part I of this review, antidepressant pharmacology, adverse effects, and drug interactions with adrenergic agonists will be discussed. In part II, drug interactions with sedation and general anesthetics will be reviewed. Bleeding effects and serotonin syndrome implications in anesthetic practice will also be highlighted.
在美国，数以百万计的患者服用抗抑郁药物来治疗抑郁症或焦虑症。一些抗抑郁药物被超适应症处方用于治疗慢性疼痛、精力不足和经期症状等问题。抗抑郁药物是一大类广泛的药物，但更常见的药物类别包括三环类抗抑郁药、选择性5-羟色胺再摄取抑制剂、5-羟色胺-去甲肾上腺素再摄取抑制剂和单胺氧化酶抑制剂。一个杂类或“非典型”类别涵盖了其他药物。一些声称具有抗抑郁活性的草药补充剂也将被讨论。在本综述的第一部分，将讨论抗抑郁药物的药理学、不良反应以及与肾上腺素能激动剂的药物相互作用。在第二部分，将回顾与镇静和全身麻醉剂的药物相互作用。麻醉实践中的出血效应和5-羟色胺综合征影响也将被强调。
