停用抗抑郁药治疗抑郁症——支持与反对的证据有哪些？
Deprescribing antidepressants for depression - what is the evidence for and against?
作者信息
Looi Jeffrey Cl, Allison Stephen, Bastiampillai Tarun, Kisely Steve, Maguire Paul A, Woon Luke S-C, Anderson Katrina, Malhi Gin S
机构信息
Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra, ACT, Australia; Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.
Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
出版信息
Australas Psychiatry. 2025 Feb;33(1):12-17. doi: 10.1177/10398562241282377. Epub 2024 Sep 6.
OBJECTIVE
Recent guidelines suggest that the overall quantity and duration of antidepressant prescriptions should be reduced. In this paper, we comment on the evidence both for and against this view.
METHODS
We critically review the arguments proposed by proponents of antidepressant deprescribing in the context of the evidence-base for the treatment of depression.
RESULTS
Proponents of deprescribing do not address the substantive issues of whether inappropriate prescribing has been demonstrated, and when prescribing is needed. Their arguments for deprescribing are rebutted in this context.
CONCLUSIONS
Whether or not to deprescribe antidepressant medication needs to take into consideration the risk-benefit profile of the decision, the responsibility for which needs to be shared and based on the context of the patient's depression, their preferences, experiences and perspectives.
目的
近期指南建议应减少抗抑郁药处方的总量及疗程。在本文中，我们对支持和反对这一观点的证据进行评论。
方法
我们在抑郁症治疗证据基础的背景下，批判性地审视抗抑郁药减药支持者提出的论点。
结果
减药支持者未解决是否已证明存在不适当处方以及何时需要处方的实质性问题。在此背景下，他们关于减药的论点遭到反驳。
结论
是否停用抗抑郁药需要考虑该决定的风险效益概况，对此责任需要分担，并基于患者抑郁症的背景、他们的偏好、经历和观点。
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