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医源性抑郁症(作者译)

[Iatrogenic depression (author's transl)].

作者信息

Chevalier J F, Ginestet D

出版信息

Encephale. 1979;5(5 Suppl):567-78.

PMID:44864
Abstract

A number of drugs are traditionally blamed for causing depression: in general medicine, the antihypertensives, the oral contraceptives and the appetite suppressants; in psychiatry, the neuroleptics. The identification of iatrogenic depression is difficult methodologically, for two reasons: 1. Detection of the depression. 2. Linking convincingly that state of depression with the administration of a particular drug, given the presence of many non-pharmacological factors. The literature and the experience of clinicians provide fairly contradictory evidence, but an analysis of published work calls for the following observations: --the type and severity of depression are rarely specified;--a history of psychiatric disorder is commonly stressed;--the specific role of the disability caused by physical or mental illness and the need to use palliative rather than curative measures are usually underestimated;--biochemically, it is surprising that the effects which some of these drugs are known to have upon the cerebral amines do not cause more depression of mood. In fact, if we consider how widely the drugs incriminated are used, it is clear that real drug-caused depression is rather uncommon.

摘要

传统上,有多种药物被认为会导致抑郁:在普通医学中,有抗高血压药、口服避孕药和食欲抑制剂;在精神病学领域,有抗精神病药。从方法学角度来看,识别医源性抑郁很困难,原因有两点:1. 抑郁的检测。2. 鉴于存在许多非药理学因素,要令人信服地将抑郁状态与特定药物的使用联系起来。文献和临床医生的经验提供了相当矛盾的证据,但对已发表研究的分析得出以下观察结果:——抑郁的类型和严重程度很少被明确指出;——通常强调有精神疾病史;——身体或精神疾病导致的残疾的具体作用以及使用姑息性而非治愈性措施的必要性通常被低估;——从生化角度来看,令人惊讶的是,已知这些药物中的一些对脑胺有影响,但并未导致更多的情绪低落。事实上,如果我们考虑到被指控的药物使用范围有多广,很明显真正由药物引起的抑郁相当罕见。

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