Strategies for the rapid treatment of depression
Strategies for the rapid treatment of depression
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DOI：
10.1002/hup.248.abs
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发表时间：
2001-03-01
影响因子：
1.7
通讯作者：
Miller, FE
中科院分区：
文献类型：
--
作者：
Miller, FE
本文的目的是回顾目前的文献有关的时间过程的抗抑郁作用的测定。此外，这项工作探讨了研究的安全性和有效性的药理学技术，以加速抗抑郁药物的治疗效果。使用MEDLINE数据库，采用关键词抗抑郁药、快速和加速，完成了与加速抗抑郁药药物作用策略相关的文献综述。大量证据表明，抗抑郁药物的起效有数周的潜伏期。这种潜伏期似乎适用于几乎所有的标准抗抑郁药，并可能反映了缓慢的适应性变化的刺激事件增加单胺水平。有几种策略作为加速抗抑郁药物治疗效果的潜在策略受到了关注。这些措施包括使用高初始剂量的某些药剂，以及使用初始增强策略。具体而言，存在的研究表明，使用高初始剂量的三环类抗抑郁药或文拉法辛可加速抗抑郁作用，以及使用精神兴奋剂、锂或吲哚洛尔初始增强可加速抗抑郁作用。考虑到与严重抑郁症相关的发病率和死亡率，迫切需要探索更快达到抗抑郁效果的方法。许多初步研究提出了快速治疗抑郁症的策略，每一种都具有明显的高度安全性。需要在更仔细定义的患者人群中进行进一步研究，并利用先进的技术评估抗抑郁药的起效。版权所有（C）2001约翰威利父子有限公司
The purpose of this article is to review current literature relating to the determination of the time course of antidepressant effects. Further, this work explores studies examining the safety and effectiveness of pharmacological techniques for accelerating the therapeutic effects of antidepressant medication. A review of the literature pertaining to strategies for accelerating antidepressant medication effects was accomplished using the MEDLINE database, employing the key title words, antidepressant, rapid, and accelerating. A preponderance of evidence suggests that there is a multiple week latency for the onset of action of antidepressant medications. This latency appears to apply to virtually all standard antidepressants and may reflect slow adaptive changes to the inciting event of increased monoamine levels. Several strategies have received attention as potential strategies with which to accelerate the therapeutic effects of antidepressant medications. These include the use of high initial doses of some agents and also the use of initial augmentation strategies. Specifically, studies exist suggesting the acceleration of antidepressant effects using high initial doses of tricyclic antidepressants or venlafaxine, as well as the potential for acceleration by using initial augmentation with psychostimulants, lithium, or pindolol. Considering the morbidity and mortality associated with severe depression, a critical need exist far the exploration of ways in which to achieve antidepressant effects more quickly. A number of preliminary studies suggest strategies for the rapid treatment of depression, each with an apparent high degree of safety. Further investigations in more carefully defined patient populations and utilizing advances in the techniques for assessing antidepressant onset are needed. Copyright (C) 2001 John Wiley & Sons, Ltd.