SEROQUEL (QUETIAPINE) WITH FLUOXETINE FOR IMPROVING ANTIDEPRESSANT RESPONSE

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。最新的一类抗抑郁药，选择性5-羟色胺再摄取抑制剂(SSRIs)，是最广泛开出的精神科药物类别，也是最广泛开出的药物之一。尽管这些目前可用的抗抑郁药物是安全有效的，但仍有一些局限性。首先，这些药物需要几周的时间才能起作用。尽管在给药后不久，突触中的5-羟色胺增加，但所有可用的受体都被淹没了。因此，充分的抗抑郁作用很可能是神经元变化的结果，可能需要至少两周，或者最多六周。其次，失眠患者通常需要额外的催眠药物，最常见的是苯二氮类药物。滥用和耐受性的高可能性使这些药物不太理想。较新的催眠药仅适用于短期治疗失眠。第三，许多抑郁症患者伴随而来的是高度的焦虑和焦虑。在某些情况下，这些症状在服用SSRIs的最初几天会变得更加严重。最后，对抗抑郁药物的反应往往是不完全的，许多患者仍然经历着残留的抑郁症状，这些症状已被证明会导致高复发风险。已经进行了许多尝试来克服这些问题，但我们认为Seroquel(奎硫平)联合给药可能是理想的。在我们自己治疗严重抑郁发作的患者的经验中，我们发现联合使用奎硫平和SSRI抗抑郁药往往能迅速缓解失眠和焦虑，阻断SSRI的激活作用，加快抗抑郁作用的起效，并提高抗抑郁药反应的整体质量。此外，奎硫平在这组患者中耐受性极好。我们相信，使用奎硫平辅助治疗重度抑郁发作患者，将在加快抗抑郁作用的起效和改善整体反应质量方面取得重大进步。目前，在精神科诊所接受治疗的抑郁症患者中，超过三分之二的人至少接受一种其他药物治疗，通常是抗焦虑药物或催眠药。在我们看来，奎硫平对这些患者中的许多人来说将是比目前使用的药物更好的选择。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The newest class of antidepressants, the selective serotonin reuptake inhibitors (SSRIs), are the most widely prescribed class of psychiatric medications and are among the most widely prescribed pharmaceuticals overall. Although these currently available antidepressants are safe and effective, there are still a number of limitations. First, the medications take several weeks to work. Although there is an increase of serotonin in the synapse shortly after drug administration, all available receptors are flooded. Full antidepressant effect, therefore, most likely occurs as a result of neuronal changes that may take at least two weeks, or up to six weeks. Second, patients with insomnia often require additional hypnotic medications, most often benzodiazepines. The high potential for abuse and tolerance make these drugs less than ideal. Newer hypnotics are indicated only for short-term treatment of insomnia. Third, many patients with depression suffer from concomitant high levels of anxiety and agitation. In some cases, these symptoms are made even worse in the initial days of taking SSRIs. Finally, the response to antidepressant medications is often incomplete, with many patients still experiencing residual depressive symptoms that have been shown to lead to high risk of relapse. Many attempts have been made to overcome these problems, but we believe that Seroquel (Quetiapine) co-administration could be ideal. In our own experience treating patients with major depressive episodes, we have found that co-prescribing quetiapine with an SSRI antidepressant often leads to rapid resolution of insomnia and anxiety, blocks activating effects of the SSRI, speeds the onset of the antidepressant effect, and improves the overall quality of the antidepressant response. Furthermore, Quetiapine is extremely well tolerated in this group of patients. We believe that the use of adjunctive Quetiapine in the treatment of patients suffering from major depressive episode will be a significant advance in terms of speeding onset of antidepressant action and improving the overall quality of response. Currently, more than two-thirds of patients with depression treated in psychiatric clinics receive at least one other medication, very frequently an anxiolytic or hypnotic. Quetiapine would, in our opinion, be a better option for many of these patients than currently used agents.