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首页> 外文期刊>The journal of clinical psychiatry >Achieving remission and managing relapse in depression.
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Achieving remission and managing relapse in depression.

机译：实现缓解并控制抑郁症的复发。

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Although antidepressants are effective, no more than one third of the depressed patients who begin treatment achieve full remission within 8 weeks of therapy. Remission, defined as virtually complete relief of symptoms and return to full functioning in all areas of life, should be thought of as the optimal goal for the initial phase of treatment of depression. This goal is recommended because residual symptoms (i.e., response without remission) are associated with a myriad of risks, including a higher rate of relapse. When compared with monotherapy, selective serotonin reuptake inhibitor (i.e., the current first-line standard of care) strategies may improve remission rates. These strategies include using maximally tolerated (i.e., higher than usual) doses of medication, switching to an antidepressant thought to have more than one mechanism of action, combining dissimilar medications (to presumably treat a broader range of symptoms), and using a combination of psychotherapy and medication. Ensuring thatpatients are indeed adherent with treatment is also worthwhile before assuming that a treatment has failed.
机译：尽管抗抑郁药有效，但开始治疗的抑郁症患者中，不超过三分之一的患者在治疗后8周内可完全缓解。缓解被定义为实际上可以完全缓解症状并在生活的所有领域恢复全功能，应该被认为是抑郁症治疗初期的最佳目标。建议使用此目标，因为残留症状（即无缓解的反应）会带来多种风险，包括更高的复发率。与单一疗法相比，选择性5-羟色胺再摄取抑制剂（即当前的一线治疗标准）策略可以提高缓解率。这些策略包括使用最大耐受剂量（即，比平时更高）的药物，转换为被认为具有多种作用机制的抗抑郁药，联合使用不同的药物（以治疗更广泛的症状）以及结合使用心理治疗和药物治疗。在假设治疗失败之前，确保患者确实坚持治疗也是值得的。

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