抗抑郁药停药综合征:最新临床综述。

Antidepressant discontinuation syndrome: A state-of-the-art clinical review.

作者信息

Fornaro M, Cattaneo C I, De Berardis D, Ressico F V, Martinotti G, Vieta E

机构信息

Department of Psychiatry, Federico II University of Naples, via Pansini n.5, building 18, Psychiatry, Naples ZIP 80131, Italy.

Department of Mental Health, Borgomanero ASL, Novara, Italy.

出版信息

Eur Neuropsychopharmacol. 2023 Jan;66:1-10. doi: 10.1016/j.euroneuro.2022.10.005. Epub 2022 Nov 4.

Abstract

Antidepressant drugs are prescribed to patients with depressive, anxiety disorders, and other conditions. Evidence about antidepressant discontinuation syndrome (ADS) and related outcomes is sparse, although potentially burdensome in some patients. The present state-of-the-art review aims to appraise the most current evidence about ADS critically. ADS has been documented for most antidepressant drugs, although most literature focuses on selective serotonin reuptake inhibitors prescribed for depression. While down-titration cannot exclude the chance of ADS, it is nonetheless warranted in the clinical setting, especially for short half-life and sedative compounds such as paroxetine. Integrative management with concurrent pharmacotherapy and psychotherapy may minimize the eventual unpleasant effects arising within the discontinuation process. In addition, patient-tailored interventions and education should be part of the discontinuation strategy. Future research must rely on broadly accepted definitions for ADS and related phenomena such as antidepressant withdrawal and shed further light on the underpinning neurobiology. Discriminating between ADS-related phenomena and relapse of depression is likewise warranted, along with a neuroscience-based nomenclature instead of a class one.

摘要

抗抑郁药物被开给患有抑郁症、焦虑症和其他病症的患者。关于抗抑郁药停药综合征(ADS)及相关后果的证据稀少,尽管在某些患者中可能会造成负担。本最新综述旨在严格评估关于ADS的最新证据。大多数抗抑郁药物都有ADS的记录,尽管大多数文献关注的是用于治疗抑郁症的选择性5-羟色胺再摄取抑制剂。虽然逐渐减药不能排除发生ADS的可能性,但在临床环境中这样做仍然是必要的,尤其是对于半衰期短的镇静类化合物,如帕罗西汀。药物治疗与心理治疗同时进行的综合管理可以将停药过程中最终出现的不良影响降至最低。此外,针对患者的干预措施和教育应该成为停药策略的一部分。未来的研究必须依赖对ADS及抗抑郁药戒断等相关现象的广泛接受的定义,并进一步阐明其潜在的神经生物学机制。区分ADS相关现象和抑郁症复发同样必要,同时需要一个基于神经科学的命名法,而不是基于药物类别的命名法。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索