基于正念认知疗法联合抗抑郁药物治疗抑郁症的有效性分析

目的:分析正念认知疗法联合抗抑郁药物治疗抑郁症的有效性.方法:纳入本院收治的抑郁症患者作为研究对象,共60例,就诊时间2019.6～2020.6,采取随机方法分组为对照组(30例)、研究组(30例),予以对照组抗抑郁药物治疗,予以研究组正念认知疗法联合抗抑郁药物治疗.结果:两组患者治疗前HAMD评分、自杀意念评分、SD...     

抑郁症的临床表现与药物治疗

目的探讨抑郁症的临床表现、抗抑郁药物的应用。方法选取2009年收治的80例抑郁症患者的临床资料进行回顾性分析。结果采用新型抗抑郁药物是目前的标准治疗方案。结论对发生治疗抵抗的无精神病症状的抑郁症患者,新型抗精神病药尤其是利培酮和奥氮平能有效增强抗抑郁药物的疗效。     

抑郁症治疗药物研究的最新进展

抑郁症是临床上一种十分常见的精神类疾病,近年来其发病率也是在不断上升中。而且此病的治疗十分困难。目前用于抑郁症治疗的药物主要有:三环类抗抑郁药物、单胺氧化酶抑制剂、5-HT及NA再摄取抑制药(SNRIs)、NA及NA再摄取抑制药(NDRIs)以及最新发现的新靶点类药物神经类固醇、吲哚胺2,3-双加氧酶以及激素类药物等。本文就近年来抗抑郁药研究的进展以及各药物对抑郁症的治疗效果作一综述。     

抑郁症治疗药物研究进展

自20世纪80年代以来,各种抗抑郁药异军突起、种类繁多、结构各异,不同作用机制的抗抑郁药不断问世．并在临床得到广泛应用。现对各种新型抗抑郁药物的作用特点及临床应用加以概述和探讨。     

抑郁症药物治疗新进展

不管国内还是国外 ,抑郁症的发病率呈上升的趋势。其治疗一直是比较棘手的问题。较早的抗抑郁药 ,较早的抗抑郁药例如异环类抗抑郁药 [ＨＣＡｓ ,包括三环类 (ＴＣＡｓ)及四环类抗抑郁药 ]及单胺氧化酶抑制剂 (ＭＡＯＩｓ) ,临床实践证明为有效的药物 ,但其不良反应常使药物不能充分发挥其疗效 ,患者对这些药物的耐受性及依从性均较差。与老一代的抗抑郁药相比 ,大多新抗抑郁药不仅能有效治疗抑郁 ,而且扩大治疗范围 ,提高耐受性、安全性及依从性 ,减少药物相互作用等。1　增强ＮＥ作用的抗抑郁药抗抑郁药的作用机制之一为增强中枢神经系统(…     

抗抑郁药物治疗功能性消化不良效果观察

功能性消化不良 (FD)是常见的消化系统疾病 ,研究表明 87% FD患者与精神因素密切相关 ,其病因的关键启动因素可能是心理障碍。本文就抗抑郁药在 FD治疗中的作用作进一步探讨。1　资料与方法1 .1　一般资料 :选择 2 0 0 1年 4月至 2 0 0 3年 4月患者 88例 ,男性 2 6例 ,女性 6 2     

老年抑郁症及其药物治疗进展

目的阐述老年抑郁症的发病机理及其目前的药物治疗进展。方法查阅分析和归纳近年来国内外相关文献。结果与结论老年抑郁症具有病因复杂、不易被察觉和并发症多等特点，可针对患者特点选取不同的药物治疗，要遵从从低剂量开始缓慢加至常规治疗量和长期治疗以预防复发的治疗原则。     

临床药师参与老年冠心病患者抗抑郁药物治疗2例

老年冠心病患者易合并抑郁状态,对预后有不良影响。对于伴发抑郁的老年冠心病患者,合理的抗抑郁药物治疗是改善预后的关键因素。临床药师结合患者基础病情及联合用药情况,提出可行建议,协助参与2例老年冠心病患者抗抑郁药物选择、用法用量及监护方案的制定,优选潜在不良反应小、安全性高及适合患者病情的抗抑郁药物。患者服用适宜的抗抑郁药物后,抑郁状态好转,且未出现不良事件。治疗过程中,临床药师通过查阅国内外文献并结合患者具体病情,在抗抑郁药物选择和用药监护中发挥了相应作用,并总结经验,为今后合理使用抗抑郁药物提供参考。     

高频重复经颅磁刺激联合抗抑郁药物治疗抑郁症的临床作用

目的分析高频重复经颅磁刺激(rTMS)联合抗抑郁药物治疗抑郁症的临床效果。方法抽调我院收治的150例抑郁症患者,随机数字法分为两组,对照组70例单用抗抑郁药物治疗,观察组80例采用高频重复经颅磁刺激治疗,比较两组抑郁治疗效果。结果观察组患者的治疗总有效率、治疗后的2周、4周后的HAMD评分与对照组相比差异显著有统计学意义(P <0.05),但两组入组时、治疗后的不良反应对比无统计学意义(P> 0.05)。结论高频重复经颅磁刺激联合抗抑郁药物治疗抑郁症,可有效改善患者抑郁症状,应用效果显著。     

利培酮联合抗抑郁药物治疗抑郁症对照研究的Meta分析

目的:评价利培酮联合抗抑郁药物与抗抑郁药物单一治疗抑郁症的有效性与安全性的差异。方法:应用循证医学方法对符合标准的10项研究进行分析,评价利培酮联合抗抑郁药物与抗抑郁药物单一治疗抑郁症的疗效、效应大小、痊愈率以及副作用的差异。结果:同质性检验:(1)有效性:χ2=7.26,df=9(P>0.05);(2)安全性:χ2=3.41,df=2(P>0.05)。综合检验:研究组与对照组在第1、2、4、6、8周末的综合检验分别为Z1=14.19(P<0.01)、Z2=14.00(P<0.01)、Z4=17.40(P<0.01)、Z6=12.10(P<0.01)、Z8=5.94(P<0.01)。效应大小:无论是研究组还是对照组,在第1、2、4、6、8周末与治疗前进行比较的治疗效应大多数达到0.5以上;研究组与对照组干预处理效应的差异效应在不同时段的差异效应都大于0.8。有效性比较:应用固定效应模型或随机效应模型显示研究组所有时段痊愈率、显效率均非常显著高于对照组,而无效率低于对照组(8周末除外)。副作用:两组之间的副作用差异没有显著性(Z=0.20～1.15,P>0.05)。结论:小剂量利培酮联合抗抑郁药物治疗抑郁症是一种良好的方法,可能特别适宜于难治性抑郁症。     

北京地区29家基层医疗机构2011年抗抑郁药采购情况分析

目的:研究北京地区29家基层医疗机构2011年抗抑郁药采购情况。方法:对参与"北京基层医疗机构药物利用与评价研究课题"的29家基层医疗机构2011年抗抑郁药的采购情况进行统计。结果:北京地区29家基层医疗机构2011年抗抑郁药采购情况按药品名称、生产厂家、月采购量、医院归属地和分级统计见正文。结论:采购药品以选择性5-羟色胺再摄取抑制剂为主,药品生产厂商以中美天津史克制药有限公司、西安杨森制药有限公司、美国礼来公司占优势。冬季采购数量较大。郊区社区医院和二级医院的采购数量和金额要高于市区社区医院和一级医院。     

抗抑郁药用于疼痛治疗的研究进展

慢性痛或神经痛是一种临床综合征,常伴有抑郁障碍,严重影响患者生活质量.对于神经痛,常规镇痛药物、甚至麻醉性镇痛药经常无效,而抗抑郁药、抗精神病药和抗癫痫药物等则有效.本文综述了抗抑郁药用于镇痛的作用机制和不同类型的抗抑郁药在疼痛治疗中的应用,旨在为疼痛的临床治疗提供参考.     

Antidepressants and memory: A review

Antidepressant medications have been in general use since the late 1950s. Many patients are treated as outpatients and often continue with their normal routines during treatment. Individuals may undertake activities where any change in memory functioning, negative or positive, might have important consequences. Furthermore, many antidepressants have similar efficacy. Information about differential effects upon memory would seem valuable information for the clinician to have at his or her disposal. This paper reviews available evidence on the effects of antidepressants on human memory. Many studies have involved the single or short-term administration of antidepressants to healthy volunteers, thereby not acknowledging that depression per se has a negative impact on memory processes. Even in the studies on patient samples, groups very with regard to type and severity of depression, dosage and duration of treatment. Limited evidence, however, does suggest that antidepressants may exert differential effects upon memory functioning which could be predicted from their action on specific neurotransmitter system.     

噻奈普汀、帕罗西汀治疗老年抑郁症疗效研究

目的：观察噻萘普汀（达体朗）治疗老年抑郁症的疗效和安全性。方法：随机将50例老年抑郁症患者分为噻奈普汀组、帕罗西汀组各25例。疗程6周，采用汉密尔顿抑郁量表（HAMD）和副反应量表（TESS）法，在治疗前，治疗后第1，2，4，6周，分别评定药物疗效和不良反应。结果：两组疗效差异不显著，HAMD总分及各因子分再治疗后2～6周均较治疗前显著降低（P〈0．01），治疗结束时TESS评分噻奈普汀组低于帕罗西汀组（P〈0．01）。结论：该药治疗老年抑郁症疗效好，不良反应少。     

Brain Functional Effects of Psychopharmacological Treatment in Major Depression: A Focus on Neural Circuitry of Affective Processing

In the last two decades, neuroimaging research has reached a much deeper understanding of the neurobiological underpinnings of major depression (MD) and has converged on functional alterations in limbic and prefrontal neural networks, which are mainly linked to altered emotional processing observed in MD patients. To date, a considerable number of studies have sought to investigate how these neural networks change with pharmacological antidepressant treatment. In the current review, we therefore discuss results from a) pharmacological functional magnetic resonance imaging (fMRI) studies investigating the effects of selective serotonin or noradrenalin reuptake inhibitors on neural activation patterns in relation to emotional processing in healthy individuals, b) treatment studies in patients with unipolar depression assessing changes in neural activation patterns before and after antidepressant pharmacotherapy, and c) predictive neural biomarkers of clinical response in depression. Comparing results from pharmacological fMRI studies in healthy individuals and treatment studies in depressed patients nicely showed parallel findings, mainly for a reduction of limbic activation in response to negative stimuli. A thorough investigation of the empirical findings highlights the importance of the specific paradigm employed in every study which may account for some of the discrepant findings reported in treatment studies in depressed patients.     

草酸艾司西酞普兰与米安色林治疗老年抑郁症各46例对照研究

目的探讨草酸艾司西酞普兰与米安色林治疗老年抑郁症的疗效和安全性。方法 92例符合CCMD-3抑郁症诊断标准的老年患者,随机分为草酸艾司西酞普兰组和米安色林组,治疗观察8周,采用汉密尔顿抑郁量表（HAMD）评定临床疗效,副反应量表（TESS）评定不良反应。结果草酸艾司西酞普兰组与米安色林组疗效相当,治疗后HAMD总分均有显著减少。草酸艾司西酞普兰显效较快,不良反应更少。结论草酸艾司西酞普兰是治疗老年性抑郁症的理想药物。     

A Criticism of the Practice of Prescribing Subtherapeutic Doses of Antidepressants for the Treatment of Depression

At doses greater than 125–150 mg daily, tricyclic antidepressants (TCAs) have been shown to be effective in patients with depressive illness. There is nevertheless, a pronounced tendency in general practice to prescribe antidepressants at half the dose likely to be prescribed for the same patient by a psychiatrist. The principal motivation for subtherapeutic dosing in primary care is to avoid the side-effects of TCAs which are likely to deter patients from complying with treatment. The misconception also prevails among some general practitioners that patients seen in general practice have less severe disorders and therefore require a reduced dose. Yet there is no clinical evidence to show that at doses of 75 mg daily or lower, TCAs are effective in the treatment of depressive illness. It is against all the principles of therapeutics to prescribe a given drug at a dosage below its therapeutic level. A more rational strategy would be to select a better tolerated antidepressant at the outset, such as one of the second generation antidepressants.     

The Effects of Calorie Restriction in Depression and Potential Mechanisms

Depression, also called major depressive disorder, is a neuropsychiatric disorder jeopardizing an increasing number of the population worldwide. To date, a large number of studies have devoted great attention to this problematic condition and raised several hypotheses of depression. Based on these theories, many antidepressant drugs were developed for the treatment of depression. Yet, the depressed patients are often refractory to the antidepressant therapies. Recently, increasing experimental evidences demonstrated the effects of calorie restriction in neuroendocrine system and in depression. Both basic and clinical investigations indicated that short-term calorie restriction might induce an antidepressant efficacy in depression, providing a novel avenue for treatment. Molecular basis underlying the antidepressant actions of calorie restriction might involve multiple physiological processes, primarily including orexin signaling activation, increased CREB phosphorylation and neurotrophic effects, release of endorphin and ketone production. However, the effects of chronic calorie restriction were quite controversial, in the cases that it often resulted in the long-term detrimental effects via inhibiting the function of 5-HT system and decreasing leptin levels. Here we review such dual effects of calorie restriction in depression and potential molecular basis behind these effects, especially focusing on antidepressant effects.     

艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的对照研究

目的探讨艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的临床疗效及安全性。方法将68例患者随机分为A组和B组,各34例,A组口服草酸艾司西酞普兰,B组口服帕罗西汀。两组于治疗前和治疗后1,2,4,8周末采用汉密尔顿抑郁量表(HAMD)评定疗效,不良反应量表(TESS)评定不良反应。结果两组治疗后HAMD评分均较治疗前显著下降,差异有统计学意义(P<0.01);A组和B组疗效总有效率分别为94.12%和91.18%,不良反应率分别为35.29%和38.24%,差异均无统计学意义(P>0.05)。结论艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的疗效相当,但艾司西酞普兰起效更快,不良反应更轻,适合作为老年脑卒中后抑郁患者的一线用药。     

Thyroxine Augmentation of Fluoxetine Treatment for Resistant Depression in the Elderly: An Open Trial

Drug resistant depression is a confounding entity. More so in populations of elderly depressives where addition of lithium or antidepressant combinations are possibly hazardous. We present an open-trial of thyroxine in elderly patients diagnosed as suffering from resistant depression. Methods—Thyroxine 50 mcg/day was added to fluoxetine 20 mg/day in patients who did not respond to previous, non-SSRI, antidepressant treatment (6 weeks), nor to an additional 6 weeks of fluoxetine. Subjects—Subjects were diagnosed as suffering from major depression, according to DSM-III-R criteria. All had normal thyroid function tests (TSH and FT₄). There were 15 patients in our series: nine females, six males; mean age 72·1 years (±6·5). Results—Patients depression severity was graded using the Hamilton Depression Rating Scale at baseline (before thyroxine augmentation), and 4 weeks after initiation of treatment. Ten of 15 patients responded to thyroxine augmentation (HDRS<10), 3/15 showed no improvement of HDRS scores and two dropped out due to adverse effects: diarrhoea and tachycardia. Conclusions—Thyroxine augmentation of fluoxetine is effective in elderly subjects resistant to standard treatment, and is relatively safe.