老年人使用的抗抑郁药物。

Antidepressant drugs in the elderly.

作者信息

Gareri P, Stilo G, Bevacqua I, Mattace R, Ferreri G, De Sarro G

机构信息

Department of Clinical and Experimental Medicine, Faculty of Medicine, Policlinico Materdomini, Catanzaro, Italy.

出版信息

Gen Pharmacol. 1998 Apr;30(4):465-75. doi: 10.1016/s0306-3623(97)00070-0.

DOI:10.1016/s0306-3623(97)00070-0

Abstract

In this article some of the most important and tolerated drugs in the elderly are reviewed. 2. Tricyclic antidepressants have to be used carefully because of their important side effects. Nortriptyline and desipramine appear to be the best tolerated tricyclics in old people. 3. Second generation antidepressants are preferred for the elderly and those patients with heart disease as they have milder side effects and are less toxic in overdose. 4. MAO inhibitors are useful drugs in resistant forms of depression in which the above mentioned drugs have no efficacy and the last generation drugs (reversible MAO inhibitors), such as moclobemide, seem to be very successful. 5. Lithium is sometimes used especially to prevent recurrence of depression, even if its use is limited in old patients due to its side effects. 6. Psychotherapy is often used as an adjunct to pharmacotherapy, while electroconvulsant therapy is used only in the elderly patients with severe depression, high risk of suicide, or drug-resistant forms.

摘要

本文对老年人使用的一些最重要且耐受性良好的药物进行了综述。2. 三环类抗抑郁药因其重要的副作用必须谨慎使用。去甲替林和地昔帕明似乎是老年人耐受性最好的三环类药物。3. 第二代抗抑郁药更适合老年人及患有心脏病的患者，因为它们副作用较轻，过量服用时毒性也较小。4. 单胺氧化酶抑制剂对于上述药物无效的难治性抑郁症是有用的药物，而最后一代药物（可逆性单胺氧化酶抑制剂），如吗氯贝胺，似乎非常有效。5. 锂盐有时会被使用，特别是用于预防抑郁症复发，即使由于其副作用，老年患者使用受到限制。6. 心理治疗常作为药物治疗的辅助手段，而电惊厥治疗仅用于患有严重抑郁症、自杀风险高或药物难治性的老年患者。