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首页> 外文期刊>The journal of clinical psychiatry >What role do atypical antipsychotic drugs have in treatment-resistant depression?
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What role do atypical antipsychotic drugs have in treatment-resistant depression?

机译：非典型抗精神病药在抗药性抑郁症中起什么作用？

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Despite significant advances in the treatment of depression, many patients fail to respond to treatment with adequate dose and duration. Multiple therapeutic approaches are available for the treatment of patients not responding to standard antidepressant medication. These include switching medication or combination and augmentation strategies. A substantial number of patients do not respond to multiple treatment trials. These patients suffer from treatment-resistant depression (TRD) and represent a challenge to the treating physician. There have been a growing number of reports on the use of atypical antipsychotics as augmenting agents in nonpsychotic TRD. Second-generation antipsychotics are less likely to provoke parkinsonian side effects. It has also been reported that these agents produce lower rates of tardive movement disorders than traditional neuroleptics. Furthermore, second-generation antipsychotics are serotonin-2A/2C antagonists, possibly allowing them to improve the efficacy and some aspects of the side effect profile of selective serotonin reuptake inhibitors (SSRIs). Weight gain and sedation are likely to be the most common adverse events of such combined therapy. In a recent controlled clinical trial, the atypical antipsychotic olanzapine was combined with fluoxetine therapy in an 8-week, double-blind clinical trial in patients with TRD. This combination drug therapy demonstrated clinical efficacy on several rating scales and showed rapid onset of action. Although more studies will be required to confirm and extend these findings, the results suggest that there may be a clinical benefit to combining atypical antipsychotics with SSRIs in nonpsychotic TRD.
机译：尽管在抑郁症的治疗方面取得了重大进展，但许多患者仍未能以足够的剂量和持续时间对治疗产生反应。多种治疗方法可用于治疗对标准抗抑郁药无反应的患者。这些措施包括换药或组合和增强策略。大量患者对多种治疗试验没有反应。这些患者患有抗药性抑郁症（TRD），对治疗医师构成挑战。关于在非精神病性TRD中使用非典型抗精神病药作为增强剂的报道越来越多。第二代抗精神病药不太可能引起帕金森氏症的副作用。还据报道，这些药物产生的迟发性运动障碍的发生率低于传统的精神安定药。此外，第二代抗精神病药是5-羟色胺-2A / 2C拮抗剂，可能使它们能够提高选择性5-羟色胺再摄取抑制剂（SSRI）的功效和副作用方面的某些方面。体重增加和镇静可能是这种联合疗法最常见的不良事件。在最近的一项对照临床试验中，非典型抗精神病药物奥氮平与氟西汀联合在一项为期8周的TRD患者双盲临床试验中联合使用。这种联合药物疗法在几个等级量表上均显示出临床疗效，并且起效迅速。尽管需要更多的研究来证实和扩展这些发现，但结果表明，在非精神病性TRD中将非典型抗精神病药与SSRI联合使用可能具有临床益处。

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