新型抗抑郁药治疗焦虑障碍的临床应用评价

目的:评价新型抗抑郁药治疗焦虑障碍的临床疗效与安全性。方法:查阅国内外近年文献,对新型抗抑郁药治疗焦虑障碍的进展和临床应用进行评价。结果与结论:新型抗抑郁药治疗焦虑障碍明显优于TCAs、MAOIs和其他非抗抑郁药。其特点是可缓解焦虑,单药治疗与抑郁共病,减少药物依赖和戒断反应,不良反应少,耐受性和安全性好。因此,新型抗抑郁药可作为治疗焦虑障碍的首选药物之一。     

抑郁症的药物治疗

抗抑郁药用于治疗抑郁症或抑郁状态.抗抑郁药对消除病人的症状、恢复正常的生活、学习和社会功能,预防复发起到很重要的作用.临床常用的治疗药物可根据其化学结构或药理活性分为:①三环类抗抑郁药.②四环类抗抑郁药.③选择性5-羟色胺再摄取抑制剂.④其他类抗抑郁药[1].     

新型抗抑郁药的临床应用评价

目的 :评价新型抗抑郁药的进展与临床应用情况 ,以供临床参考。方法 :查阅近期国内、外相关文献 ,从作用机制、类型、临床应用等方面对新型抗抑郁药进行了分析、评价。结果与结论 :新型抗抑郁药具有疗效好、不良反应少等特点 ,除用于抑郁症之外 ,还可治疗社交恐惧症、强迫症、广泛焦虑症、惊恐障碍、创伤后应激障碍、热潮红症等 ,并逐步成为治疗抑郁症及相关疾病的一线药物。     

2002年~2004年我院抗抑郁药利用分析

目的:评价我院抗抑郁药的应用现状与发展趋势。方法:对2002年~2004年我院抗抑郁药的种类、用量、销售金额、用药频度等进行回顾性分析。结果:抗抑郁药销售金额呈上升趋势,3年间分别为667.41万元、802.47万元和995.02万元。结论:抗抑郁药临床应用以氟西汀居首,新型抗抑郁药的应用也有上升趋势。     

米氮平口腔崩解片治疗抑郁症患者的临床研究概述

除了研发新药以外,现有药物新剂型的研发和应用也是治疗抑郁症的新思路。口崩剂型抗抑郁药米氮平口腔崩解片凭借其便于携带、口感良好及易于吞服等优点,作为能较好改善抑郁症患者依从性的一种剂型在临床广泛应用。本文从疾病本身的特点,结合抗抑郁药物的药理特征和不良反应,介绍米氮平口腔崩解片在抑郁症患者的临床研究情况。     

抗抑郁药的临床应用与进展

目的 介绍临床常用的抗郁抑药及其应用进展。方法 查阅国内有关文献，进行分析、归纳和综述。结果 总结了各类抗抑郁药及其代表药的药理、临床应用、用法和用量及不良反应等。结论 抗抑郁药具有良好的发展前景。     

抗抑郁药临床应用的进展

从20世纪80年代末起,由于对抗抑郁药的药理机制的深入研究,逐步研制开发出多种新型抗抑郁药,并被广泛应用于临床,这不但为抑郁的治疗提供了更多的方法及选择,而且抗抑郁药的应用范围不断扩大,还可用于治疗焦虑症、强迫症、恐怖症、     

抗抑郁新药—瑞美隆

瑞美隆(Remeron)的国际通用名是米他扎品(Mirtazapine).其药理机制与以往的各类抗抑郁药不同,被称为Nassa(Noradrenergic and Specific Serotonergic Antidepressants,去甲肾上腺素和特异的五羟色胺抗抑郁药)。本文就该药的药理特性、临床疗效及不良反应作一概述。 1 药理特性 1.1 作用机制 瑞美隆的作用机制与以前我们所知的任何一种抗抑郁药均不相同,它同时作用于去甲肾上腺素神经和5-HT神经,促使去甲肾上腺素(NA)和5-HT的神经传导,起抗抑郁作用。神经生理学研究表明,瑞美隆通过三种途径起抗抑郁作用:(1)作用于脑去甲肾上腺素突触前膜α_1自身受体,增加去甲肾上腺素神经冲动发放,促使NA释放,起部分抗抑郁作用。(2)5-HT神经冲动发放受5-HT神经细胞上的     

抗抑郁药的药理及临床应用

本文扼要介绍了抗抑郁药的分类、药理、疗程及三环类抗抑郁药的优缺点。     

2008—2010年抗抑郁药临床应用分析

目的:分析2008—2010年北京市崇文区精神病防治院抗抑郁药的应用情况和变化趋势。方法:采用WHO推荐的用药频度作为评价药物利用的指标,对抗抑郁药物品种、用量、金额、年平均增长率等进行统计分析。结果:抗抑郁药销售金额和用药频度呈逐年上升趋势,5-羟色胺再摄取抑制剂已成为一线抗抑郁药,三环类抗抑郁药的应用逐年减少。氟西汀、舍曲林、西酞普兰是我院常用抗抑郁药。结论:新型抗抑郁药的临床应用越来越多,我院抗抑郁药的整体用量呈上升趋势。     

Enhancing the technology of clinical trials and the trials model to evaluate newly developed, targeted antidepressants.

Concern about disappointing results from recent multi-center trials of new antidepressants prompted several ACNP workshops on "improving the technology of clinical trials." The workshops focused on technical problems, such as patient screening, reliability of clinical ratings, and the role of the placebo control. They aimed to determine how to more effectively apply the current clinical trials model for evaluating antidepressant drugs. The problems confronting the field of clinical trials, however, extend beyond technology. They also included conceptual issues concerning changes in the understanding of depressive disorders and of the multiple actions of antidepressant drugs. Such problems have been further complicated by the rapidly changing field of drug development itself, which is continually refining the targeting of new antidepressant agents. Drugs are increasingly being developed to try to change specific behavioral facets more rapidly and may be less likely, therefore, to act initially on "whole" disorders. To address such issues, a symposium was held in Rhodes in 2000 that focused on such conceptual changes with the goal of developing recommendations to revise the clinical evaluation model. Its purpose was to integrate new knowledge on depression and the mechanisms of action of antidepressant drugs toward developing more efficient methods of drug development. Since the evaluation process will eventually require changes in governmental policy, senior staff from the National Institute of Mental Health (NIMH) , Unites States and Food and Drug Administration (FDA), Unites States participated as well as members of academia, industry and clinical practice. Recommendations for altering clinical trial methodology were made in four areas: patient selection, methodology of evaluation, measuring onset of action, and FDA and NIMH perspectives on current practice. This article discusses these four areas and presents the consensus of the panel participants.     

Monitoring of antidepressant drug plasma levels: the next ten years.

Future studies of the relationship between plasma level and drug response in depressed patients ought to take the following facts into consideration: 1. Selective drug analytical methods must be used and subjected to quality control. Methods for the major urinary metabolite(s) of the parent drug should also be developed. 2. Each drug has individual pharmacokinetic and pharmacodynamic properties--it is unlikely that one drug will be effective in all patients even under optimal kinetic conditions. 3. The pharmacologic and biochemical effects of hitherto investigated tricyclic antidepressants correlate significantly to the concentrations of parent drug and/or its active metabolite in plasma. 4. It is more likely that a significant correlation will be found between the total tricyclic antidepressant level in plasma and the therapeutic outcome in a patient sample if the range of plasma levels is large--in this case the relatively small interindividual differences in plasma protein binding play a minor role. 5. Concomitant somatic disease may change the kinetics of antidepressant drugs. 6. The clinical methods used for selecting and rating study patients with depressive disorders must be standardized. 7. Novel rapidly acting drugs are desirable because the slow onset of action of tricyclic antidepressant seriously hamper their clinical evaluation. 8. A strong correlation between plasma concentration of an antidepressant drug and clinical outcome is strong evidence that the clinical effect is due to the drug rather than nonpharmacological factors.     

2004年～2006年我院门诊抗抑郁药应用分析

目的:分析我院2004年～2006年门诊抗抑郁药的应用情况,以期为临床合理用药提供参考。方法:收集我院2004年～2006年门诊处方资料,对药品名称、规格、单价、处方药品数量、金额进行统计,采用金额排序和用药频度进行分析。结果:新型抗抑郁药疗效确切,不良反应较少,广泛应用于临床。TCAs类因其日均费用低仍占有一定的地位。结论:抗抑郁药市场前景广阔,临床医师药师应加强用药监测,促进合理用药。     

某社区精神卫生中心2012～2014年抗抑郁药物的应用分析

目的：分析成都高新区社区精神卫生中心2012～2014年抗抑郁药物的使用情况及发展趋势,为临床合理用药提供参考。方法：回顾性统计、分析该中心2012～2014年抗抑郁药物的销售金额、用药频度（DDDs）及日均费用（DDC）。结果：该中心抗抑郁药物的销售金额逐年增长;5-羟色胺再摄取抑制剂（SSRIs）销售金额和用药频度均占据最主要地位。结论：SSRIs成为该中心抑郁病治疗的主要药物,该中心该类药物的应用状况与国内外总体用药情况基本相符。     

基于层次分析法的药品定价和报销决策模型设计

目的:提高创新药物定价和报销决策的科学性和透明度。方法:以一个假想的抗抑郁新药为例,在层次分析法的基础上建立层次结构模型并计算优先权重,综合评估影响药品定价和报销决策的多种因素并获得综合评价结果。结果与结论:模型将定价和报销决策中的部分定性因素定量化,从而提供了可靠的决策依据。虽然层次分析法在实际应用中需要探讨更多的影响因素和方法学问题,但其在药品定价和报销领域的应用是现实和可行的。     

Association between antidepressant drug use and hyponatraemia: a case-control study

AIMS: To estimate the risk of, and risk factors for, hyponatraemia associated with the use of selective serotonin reuptake inhibitors (SSRIs) compared with the use of other antidepressant drugs. METHODS: A case-control study of psychiatric in- and out-patients on antidepressant drugs performed in the mid-southern part of The Netherlands over a 2 year period. Cases (n=29) were all using antidepressant drugs with a serum sodium concentration of < or = 130 mmol l(-1) while controls (n=78) were patients on antidepressants with a normal sodium concentration (136-144 mmol l(-1)). Information on blood sodium concentrations was obtained from clinical chemistry data while information on drug use was obtained from community and hospital pharmacy databases. Medical records were used to ascertain possible risk and confounding factors. Unconditional multivariate logistic regression was used to estimate odds ratios for hyponatraemia in patients on SSRIs compared with patients on other antidepressant drugs. RESULTS: SSRIs were associated with an increased risk of hyponatraemia (OR 3.3; 95% CI 1.3, 8.6) compared with other classes of antidepressant drugs. Stratified and interaction analyses revealed that elderly patients using diuretics concomitantly with SSRIs were at the highest risk of experiencing hyponatraemia (OR 13.5; 95% CI 1.8, 101). CONCLUSIONS: SSRIs are more frequently associated with hyponatraemia than other classes of antidepressant drugs. This adverse drug reaction was more common in older patients (> or = 65 years) and in those using diuretics.     

我院2000年-2003年抗抑郁药应用分析

目的:客观评估抗抑郁药在我院的应用情况.方法:调查我院2000年-2003年抗抑郁药的销售金额,主要品种、数量以及DDDs并进行临床评价.结果:抗抑郁药销售金额、数量每年都有增长,但幅度没有抗精神失常药高.金额排序前3位的是氟西汀、文拉法新、曲唑酮,DDDs排序前3位是:黛力新、氟西汀、文拉法新.结论:抗抑郁药物是目前国内一类具有发展潜力的抗精神失常的常用药物.     

住院抑郁症患者抗抑郁药联合治疗的影响因素分析

目的：探讨住院抑郁症患者抗抑郁药联合治疗的影响因素，为临床安全用药提供参考。方法：回顾性分析374例住院抑郁症患者的社会人口学资料、临床疾病相关资料，比较抗抑郁药单一治疗（单用组）和联合治疗（联用组）的患者在出院日处方信息资料上的差异，并利用Logistic回归分析探讨抗抑郁药联合治疗的影响因素。结果：与单用组相比，联用组在年龄、居住地、婚姻状况、教育年限、起病年龄、汉密尔顿抑郁量表（HAMD）评分、合并躯体疾病、规律服药、联用抗精神病药等方面存在差异，且差异具有统计学意义（P<0.05）。多因素Logistic回归分析显示，患者的HAMD评分（OR=1.018，95% CI：1.003~1.034，P=0.022）、规律服药（OR=0.476，95% CI：0.306~0.740，P=0.001）、起病年龄（OR=2.260，95% CI：1.419~3.598，P=0.001）以及联用抗精神病药物（OR=0.411，95% CI：0.261~0.649，P<0.001）是住院抑郁症患者接受抗抑郁药物联合治疗的独立影响因素。另外，单用组和联用组不良反应发生率分别为27.0%和43.2%，两组相比差异具有统计学意义（χ²=10.860，P=0.001）。结论：HAMD评分高、起病年龄晚、不规律服药、未联用抗精神病药物是住院抑郁症患者抗抑郁药联合治疗的独立影响因素。抗抑郁药联合治疗增加不良反应发生风险，临床药师应加强对住院患者的用药监护及健康教育，有必要采取措施提升患者的用药依从性。