Low Yvette, Setia Sajita, Lima Graca
Department of Pharmacy, National University of Singapore, Singapore.
Medical Affairs, Pfizer Pte. Ltd., Singapore.
Neuropsychiatr Dis Treat. 2018 Feb 19;14:567-580. doi: 10.2147/NDT.S157708. eCollection 2018.
Psychiatric and physical conditions often coexist, and there is robust evidence that associates the frequency of depression with single and multiple physical conditions. More than half of patients with depression may have at least one chronic physical condition. Therefore, antidepressants are often used in cotherapy with other medications for the management of both psychiatric and chronic physical illnesses. The risk of drug-drug interactions (DDIs) is augmented by complex polypharmacy regimens and extended periods of treatment required, of which possible outcomes range from tolerability issues to lack of efficacy and serious adverse events. Optimal patient outcomes may be achieved through drug selection with minimal potential for DDIs. Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor approved for the treatment of adults with major depressive disorder. Pharmacokinetic studies of desvenlafaxine have shown a simple metabolic profile unique among antidepressants. This review examines the DDI profiles of antidepressants, particularly desvenlafaxine, in relation to drugs of different therapeutic areas. The summary and comparison of information available is meant to help clinicians in making informed decisions when using desvenlafaxine in patients with depression and comorbid chronic conditions.
精神疾病和身体疾病常常并存，而且有充分的证据表明抑郁症的发病率与单一和多种身体疾病相关。超过一半的抑郁症患者可能至少患有一种慢性身体疾病。因此，抗抑郁药常常与其他药物联合使用，用于治疗精神疾病和慢性身体疾病。复杂的联合用药方案以及所需的长期治疗增加了药物相互作用（DDIs）的风险，其可能的后果从耐受性问题到疗效不佳以及严重不良事件不等。通过选择具有最小药物相互作用可能性的药物，可能实现最佳的患者治疗效果。度洛西汀是一种血清素-去甲肾上腺素再摄取抑制剂，被批准用于治疗患有重度抑郁症的成年人。度洛西汀的药代动力学研究表明，其代谢特征在抗抑郁药中独一无二。本综述考察了抗抑郁药，尤其是度洛西汀，与不同治疗领域药物相关的药物相互作用情况。现有信息的总结和比较旨在帮助临床医生在为患有抑郁症和合并慢性病的患者使用度洛西汀时做出明智的决策。
