Leonard B E
University College, Galway, Republic of Ireland.
Br J Psychiatry. 1988 Apr;152:453-9. doi: 10.1192/bjp.152.4.453.
Despite the relatively high incidence of therapy-resistant depression, there is little clinical evidence to suggest that there are significant biochemical differences between therapy-resistant and therapy-responsive patients. A major problem for investigators is the lack of an internationally recognised definition of resistant depression. Also, it is possible that depressed patients with delusional symptoms or rapidly cycling affective disorders from subgroups that are more likely to be resistant to tricyclic antidepressant treatment and are therefore classified as therapy-resistant. Evidence is presented to show that an abnormality in serotonergic function may characterise some therapy-resistant depressed patients.
尽管难治性抑郁症的发病率相对较高，但几乎没有临床证据表明难治性患者与治疗反应良好的患者之间存在显著的生化差异。研究人员面临的一个主要问题是缺乏国际公认的难治性抑郁症定义。此外，患有妄想症状的抑郁症患者或快速循环型情感障碍患者可能来自更容易对三环类抗抑郁药治疗产生耐药性的亚组，因此被归类为难治性患者。有证据表明，血清素能功能异常可能是一些难治性抑郁症患者的特征。
