Katona C L
Department of Psychiatry, University College London Medical School, UK.
Eur Neuropsychopharmacol. 1995;5 Suppl:109-13. doi: 10.1016/0924-977x(95)00031-j.
The literature on pharmacological treatments of refractory depression is reviewed, with particular reference to problems in definition of treatment resistance, criteria for adequacy of treatment and the lack of controlled trial evidence for many putative treatment approaches. The results of a placebo-controlled trial of lithium augmentation of patients failing to respond to fluoxetine or lofepramine are presented. The data from this trial (particularly when analysed in combination with that in earlier, smaller published studies) establish the efficacy of lithium augmentation but illustrate the difficulty of achieving adequate plasma lithium levels and the high rate of partial response to continued antidepressant alone.
本文回顾了难治性抑郁症药物治疗的相关文献，特别提及治疗抵抗的定义问题、治疗充分性标准以及许多假定治疗方法缺乏对照试验证据的情况。文中呈现了一项针对对氟西汀或洛非帕明治疗无反应的患者进行锂盐增效的安慰剂对照试验结果。该试验数据（尤其是与早期较小规模已发表研究的数据相结合分析时）证实了锂盐增效的疗效，但也说明了达到足够血浆锂水平的困难以及仅持续使用抗抑郁药时部分缓解率较高的情况。
