SEROQUEL (QUETIAPINE) WITH FLUOXETINE FOR IMPROVING ANTIDEPRESSANT RESPONSE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。最新的一类抗抑郁药，选择性5-羟色胺再摄取抑制剂（SSRIs），是最广泛的精神病药物处方类别，也是最广泛的处方药物之一。虽然这些目前可用的抗抑郁药是安全有效的，但仍然存在一些局限性。首先，药物需要几个星期才能起作用。虽然在给药后不久，突触中的5-羟色胺增加，但所有可用的受体都被淹没。因此，完全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长达六周。其次，失眠患者通常需要额外的催眠药物，最常见的是苯二氮卓类药物。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失眠的短期治疗。第三，许多抑郁症患者伴随着高度的焦虑和激动。在某些情况下，这些症状在服用SSRIs的最初几天变得更糟。最后，对抗抑郁药物的反应往往是不完全的，许多患者仍然经历残余的抑郁症状，这些症状已被证明会导致复发的高风险。 已经进行了许多尝试来克服这些问题，但我们认为，Seroquel（Quetidine）联合管理可能是理想的。在我们自己治疗重度抑郁发作患者的经验中，我们发现，将奎替鲁与SSRI抗抑郁药共同处方通常会导致失眠和焦虑的快速解决，阻断SSRI的激活作用，加速抗抑郁作用的起效，并改善抗抑郁反应的整体质量。此外，Queti在这组患者中的耐受性非常好。 我们认为，使用抗抑郁药奎替卡松治疗重度抑郁发作患者将是一个重大进步，加快抗抑郁作用的起效，提高整体质量的反应。目前，在精神病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，通常是抗焦虑药或催眠药。在我们看来，对于许多患者来说，奎替卡松比目前使用的药物更好。

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.