为什么,什么时候,在哪里,如何,以及所谓的快速作用抗抑郁药的原因
Alan F Schatzberg1, Sanjay J Mathew2
1Kenneth T. Norris, Jr., Professor of Psychiatry and Behavioral Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. afschatz@stanford.edu.
概括
开发更快速起作用的抗抑郁药非常重要. 本综述解决了定义和测量抗抑郁药快速反应的挑战,旨在改善临床试验,以更快地治疗抑郁症.
科学领域:
- 精神病学和神经科学 精神病学和神经科学
- 药理学 药理学是指药理学的学科.
- 临床试验设计 临床试验设计
背景情况:
- 开发具有迅速发作的有效抗抑郁药物是精神病学研究的一个重要目标.
- 目前的抗抑郁药通常具有延迟的起作用,影响患者的治疗结果和治疗坚持.
- 在临床试验中定义和测量"快速反应"仍然是一个复杂的挑战.
研究的目的:
- 审查快速起作用抗抑郁药物的现状.
- 解决关于快速抗抑郁反应的定义,测量和临床意义的关键问题和问题.
- 提出一个框架来评估临床试验中的快速反应.
主要方法:
- 对抗抑郁药试验和快速起作用药物的现有文献的审查.
- 在定义快速反应时分析关键问题 (例如,时间,基于症状的标准,持久性).
- 讨论评估快速抗抑郁药效应的研究设计考虑因素.
主要成果:
- 在研究中缺乏统一的快速响应定义.
- 开始 (如第3天,第7天,第14天) 和维持效果的标准的变化.
- 确定关键的研究设计要素,包括患者选择和结果措施.
- 探索潜在的作用机制及其影响.
结论:
- 需要标准化的定义和强大的方法来准确评估快速抗抑郁药反应.
- 对于开始,持续和维持的明确标准对于评估新型抗抑郁药物至关重要.
- 一个结构化的框架可以指导研究人员和临床医生设计和解释快速起作用治疗的试验.
相关概念视频
Antidepressant Drugs: MAOIs and Other Agents
275
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
275
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
444
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
444
Antidepressant Drugs: Overview
589
Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
589
Drugs Affecting Neurotransmitter Release or Uptake
1.1K
Certain drugs can affect how neurotransmitters called catecholamines, are released or taken back up in the adrenergic neuron. They can have different effects on the body's sympathetic transmission. Reserpine, a natural compound found in the Rauwolfia shrub, blocks a transporter called vesicular monoamine transporter (VMAT), which leads to a buildup of catecholamines in the cell and reduces sympathetic transmission. Another drug called guanethidine works in multiple ways, including blocking...
1.1K
Adrenergic Agonists: Indirect-Acting Agents
1.7K
Indirect-acting adrenergic agonists potentiate the effects of endogenous catecholamines through different mechanisms without directly binding to adrenoceptors.
One mechanism involves depleting stored catecholamines by displacing them from synaptic vesicles. These agents, known as "displacers," are transported into vesicles at the expense of noradrenaline. Examples include amphetamine and tyramine, which lack a catechol moiety, resulting in prolonged action, improved oral...
One mechanism involves depleting stored catecholamines by displacing them from synaptic vesicles. These agents, known as "displacers," are transported into vesicles at the expense of noradrenaline. Examples include amphetamine and tyramine, which lack a catechol moiety, resulting in prolonged action, improved oral...
1.7K
Drug Therapy
73
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
73


