Joffe R T
Department of Psychiatry, McMaster University, Hamilton, Ont.
J Psychiatry Neurosci. 1997 Nov;22(5):327-31.
In the last few years, it has become evident that major depressive disorder often runs a chronic and recurrent course. Early effective intervention may increase the liklihood of a good long-term prognosis. The main treatment options for patients who fail to respond to antidepressant therapy and the relative advantages of each are critically reviewed. These include substitution, replacing one antidepressant with another, and augmentation/combination, in which a second antidepressant is added to the first. Particular emphasis is placed on the role of triiodothyronine (T3) in augmentation therapy. The theoretic rationale for using augmentation/combination therapy and its relative advantages and disadvantages over substitution therapy are critically reviewed.
在过去几年中，很明显重度抑郁症往往呈慢性和复发性病程。早期有效干预可能会增加获得良好长期预后的可能性。对对抗抑郁治疗无反应的患者的主要治疗选择及其各自的相对优势进行了严格审查。这些包括替代疗法，即用一种抗抑郁药替换另一种抗抑郁药，以及增效/联合疗法，即在第一种抗抑郁药的基础上加用第二种抗抑郁药。特别强调了三碘甲状腺原氨酸（T3）在增效治疗中的作用。对使用增效/联合疗法的理论依据及其相对于替代疗法的相对优缺点进行了严格审查。
