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Augmentation of phenelzine with aripiprazole and quetiapine in a treatment-resistant patient with psychotic unipolar depression: case report and literature review

机译：用精神病患者在治疗耐心患者中使用AripiPrazole和喹啉的增强素：病例报告和文献综述

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摘要

Irreversible monoamine oxidase inhibitor (MAOI) antidepressants have significant efficacy in treatment-resistant unipolar depression, but in some instances patients may not achieve remission. Among the adjunctive and augmentation strategies, certain second-generation antipsychotics (SGAs) have approval for inadequate responders to antidepressant therapy, including aripiprazole, brexpiprazole, and quetiapine, with lurasidone and the olanzapine/fluoxetine combination indicated for bipolar depression. Clinicians may eschew SGA options in part due to the limited literature on SGA-MAOI combinations, with only one published case involving aripiprazole, and none for olanzapine, lurasidone, or brexpiprazole. In addition to the limited publication history on SGA-MAOI treatment, clinicians may also be deterred by uncertainty regarding SGA mechanisms and the risk of serotonin syndrome or other adverse outcomes. This paper describes the case of a 54-year-old male with a history of psychotic unipolar depression treated with a combination of phenelzine, aripiprazole, and quetiapine, and reviews the 12 published cases of SGA-MAOI combination therapy with a focus on the pharmacological basis for serotonin syndrome, and the SGA mechanisms that should not be associated with a risk for this syndrome.
机译：不可逆的单胺氧化酶抑制剂（MAOI）抗抑郁药在治疗的单极抑制中具有显着的疗效，但在某些情况下，患者可能无法达到缓解。在辅助和增强策略中，某些第二代抗精神病药（SGAS）有批准对抗抑郁药物的抗抑郁药，包括阿里希哌唑，Brengiprazole和喹啉，其中LuraAnidone和对双极抑郁症表示的奥拉扎滨/氟西汀组合。由于SGA-MAOI组合的文献有限，临床医生可以部分地避开SGA选择，只有一个涉及阿里普哌唑的发表的案例，奥沙西扎丁，LURASIDONE或BREPIPRAZOLE。除了关于SGA-MAOI治疗的有限的出版历史之外，临床医生也可以通过关于SGA机制的不确定性以及血清素综合征或其他不利结果的风险来阻止。本文介绍了一个54岁男性的案例，具有苯脲，阿里希哌唑和喹啉治疗的精神病单极抑郁症的历史，并评论了12名已发表的SGA-MAOI联合治疗病例，重点关注药理学血清素综合征的基础，以及不应该与该综合征风险相关的SGA机制。

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