The use of monoamine oxidase inhibitors in primary care.
The use of monoamine oxidase inhibitors in primary care.
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DOI：
10.4088/jcp.11096su1c.06
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
Culpepper, Larry
中科院分区：
文献类型：
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作者：
Culpepper, Larry
尽管初级保健临床医生在管理重度抑郁症患者方面已经发展了相当多的专业知识，并且目前有一系列的治疗策略，但一些患者仍然未能达到缓解。有两种策略已经不再常用：用单胺氧化酶抑制剂（MAOIs）治疗患者，以及在选择抗抑郁治疗时根据诊断对患者进行亚分组。单胺氧化酶抑制剂变得不那么受欢迎，因为其他治疗方法被认为更安全，更容易使用。然而，一种新的经皮MAOI配方限制了口服MAOI的饮食限制，可能值得考虑在几次治疗试验失败的患者中使用这类药物。尽管经皮MAOI患者饮食不良事件的可能性较小，但临床医生仍应警惕药物相互作用，并遵守推荐的洗脱期。可能从MAOI治疗中受益的患者包括那些患有难治性抑郁症、非典型抑郁症、焦虑或无能性双相抑郁症的患者，以及那些在使用其他药物时出现无法忍受的代谢或性副作用的患者。
Although primary care clinicians have developed considerable expertise in managing patients with major depressive disorder, and a range of treatment strategies is currently available, some patients still fail to reach remission. Two strategies have fallen out of common use: treating patients with monoamine oxidase inhibitors (MAOIs) and subgrouping patients by diagnosis when selecting antidepressant treatment. Monoamine oxidase inhibitors became less popular because other treatments were perceived to be safer and easier to use. However, a newer transdermal formulation of an MAOI that limits the need for the dietary restrictions of oral MAOIs may make it worthwhile to consider using this class of medication in patients who have failed several treatment trials. Although adverse events due to patients' diets are less likely with the transdermal MAOI, clinicians should still be alert for drug interactions and observe recommended washout periods. Patients who may benefit from MAOI treatment include those with treatment-resistant depression, atypical depression, anxiety, or anergic bipolar depression and those who have experienced intolerable metabolic or sexual side effects with other medications.