临床医生需要了解哪些关于治疗耐药抑郁症的鼻内胺?
Judy Hope1, David Copolov2, John Tiller3
1Mental Health Program, Eastern Health, Box Hill, VIC, Australia; Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia; Centre of Mental Health Education and Research, Delmont Private Hospital, Burwood, VIC, Australia.
概括
鼻腔内胺,结合抗抑郁药,显示在治疗耐药抑郁症中适度有效,为患者提供了一个新的选择. 长期使用通常是必要的,成本可能是一个重要的障碍.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 耐治疗抑郁症 (TRD) 是一个重大的临床挑战.
- 现有的抗抑郁药疗法对大量患者的有效性有限.
- 新型的治疗点和药物对管理TRD至关重要.
研究的目的:
- 为了评估鼻腔内胺在治疗耐药抑郁症患者的临床效用.
- 综合了关键试验中的证据,以分析埃斯基他明的疗效和安全性.
- 为了告知临床实践和患者选择胺治疗的情况.
主要方法:
- 一篇叙述性综述,综合了TRD中鼻内乙胺关键临床试验的数据.
- 埃斯基坦胺加抗抑郁药与安慰剂加抗抑郁药方案的比较.
- 评估疗效终点,包括缓解率,反应速度和自杀倾向.
主要成果:
- 在4周内,鼻内以斯基坦胺的缓解率比安慰剂高37%.
- 观察到自杀倾向和反应速度的快速改善.
- 在停止 (45%) 和继续 (25%) 治疗时,复发率更高.
- 副作用包括分离和高血压;没有报告精神病.
- 在以前多次抗抑郁药失败的患者中,疗效可能会降低.
结论:
- 作为口服抗抑郁药的辅助剂,鼻内胺被批准用于TRD,具有中等的疗效和可接受的耐受性.
- 长期治疗和警潜在的滥用是必不可少的.
- 高昂的无补贴费用对许多患者,尤其是澳大利亚患者来说,是一个重要的进入障碍.
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