Scott M A, Shelton P S, Gattis W
Department of Pharmacy Practice, Campbell University School of Pharmacy, Buies Creek, North Carolina 27506, USA.
Pharmacotherapy. 1996 May-Jun;16(3):352-65.
Major depression is a debilitating disorder that is often undertreated. Psychotherapy, electroconvulsive therapy, and pharmacotherapy are options for management. Tricyclic antidepressants and selective serotonin reuptake inhibitors are the cornerstones of drug therapy. Venlafaxine, a phenylethylamine antidepressant that primarily inhibits reuptake of norepinephrine and serotonin, is an alternative to those agents. It has been studied in short-term and continuation studies and appears to have efficacy similar to that of imipramine, trazodone, and fluoxetine. Moreover, venlafaxine is effective in approximately one-third of patients with treatment-resistant depression. Venlafaxine is metabolized by the P-450 enzyme system to an active metabolite O-desmethyl-venlafaxine, which is excreted renally. Nausea, somnolence, and dizziness are dose-related adverse effects that often occur with initiation of therapy. Increases in blood pressure, particularly with high dosages, also may occur. Drug-drug interactions appear to be minimal.
重度抑郁症是一种使人衰弱的疾病，常常得不到充分治疗。心理治疗、电休克治疗和药物治疗都是可供选择的治疗方法。三环类抗抑郁药和选择性5-羟色胺再摄取抑制剂是药物治疗的基石。文拉法辛是一种苯乙胺类抗抑郁药，主要抑制去甲肾上腺素和5-羟色胺的再摄取，是这些药物的替代药物。它已在短期和延续性研究中得到研究，其疗效似乎与丙咪嗪、曲唑酮和氟西汀相似。此外，文拉法辛对约三分之一的难治性抑郁症患者有效。文拉法辛经P-450酶系统代谢为活性代谢产物O-去甲基文拉法辛，经肾脏排泄。恶心、嗜睡和头晕是与剂量相关的不良反应，常在治疗开始时出现。血压升高，尤其是高剂量时，也可能发生。药物相互作用似乎很少。
