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[血清素神经传递与抑郁症的治疗选择]

[Serotonin neurotrasmission and treatment options for depression].

作者信息

Sivolap Yu P

机构信息

Sechenov First Moscow State Medical University, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(11):174-177. doi: 10.17116/jnevro2017117111174-177.

Abstract

The efficacy of modern antidepressants is largely related to their ability to enhance neurotransmission of serotonin. The medicines with serotonergic properties include trazodone, which is intermediate between tricyclic antidepressants with their powerful antidepressive effect and selective serotonin reuptake inhibitors, as first-line agents in the treatment of depression and anxiety disorders. The value of trazodone for clinical practice is determined by the effective elimination of the symptoms of major depressive disorder in combination with good tolerability, including in elderly patients. Among the advantages of trazodone is the absence of such undesirable effects as sexual dysfunction and weight gain. Trazodone has significant hypnotic and anxiolytic properties, which gives it special meaning in the treatment of depression, combined with insomnia and anxiety. It is emphasized that the beneficial effect of trazodone on sleep should not prevent its main use as a drug for treating major depressive disorder regardless of whether depression is accompanied by insomnia or not.

摘要

现代抗抑郁药的疗效很大程度上与其增强血清素神经传递的能力有关。具有血清素能特性的药物包括曲唑酮,它介于具有强大抗抑郁作用的三环类抗抑郁药和选择性血清素再摄取抑制剂之间,是治疗抑郁症和焦虑症的一线药物。曲唑酮在临床实践中的价值取决于其能有效消除重度抑郁症症状,且耐受性良好,包括老年患者。曲唑酮的优点之一是不存在性功能障碍和体重增加等不良影响。曲唑酮具有显著的催眠和抗焦虑特性,这使其在治疗伴有失眠和焦虑的抑郁症时具有特殊意义。需要强调的是,无论抑郁症是否伴有失眠,曲唑酮对睡眠的有益作用都不应妨碍其作为治疗重度抑郁症药物的主要用途。

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