胺和慢性耐治疗抑郁症:现实实践和复发后的实践
Sumaya Jobnah1, Youssef Latifeh2, Dina Al Kabani2
1Program of Clinical and Hospital Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Damascus University, Damascus, Syrian Arab Republic.
BMC psychiatry
|October 29, 2024
概括
连续注入胺在治疗耐药抑郁症 (TRD) 中表现出抗抑郁作用,但复发很常见. 该研究强调了重大风险,包括增加自杀倾向,需要对临床使用进行仔细的益处危害评估.
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:
- 慢性耐治疗抑郁症 (TRD) 是一个重大的临床挑战.
- 胺在TRD患者中表现出快速但短暂的抗抑郁作用.
- 现有研究表明,不同患者的人口统计和临床形状的反应各不相同.
研究的目的:
- 在慢性TRD患者中评估连续胺注射的抗抑郁疗效.
- 评估复发后的症状严重程度和响应者的整体精神健康状况.
- 为了调查胺胺的抗抑郁作用的持续时间和相关风险.
主要方法:
- 这是一项单臂的开放性研究,涉及慢性TRD患者两周内6次胺注射 (0.5 mg/kg).
- 评估反应和缓解率,副作用和不良事件.
- 三个月的随访以评估复发和一般精神健康状况.
主要成果:
- 在18名完成者中,有12人 (66.67%) 对胺治疗有反应,其中11人 (61.11%) 在治疗后保持反应.
- 大多数响应者需要至少三次输液才能获得初始响应,只有一个患者实现了缓解.
- 在一个月内观察到高复发率,MADRS得分与基线没有显著差异.
- 严重的不良事件,包括自杀企图和严重的自杀念头,发生在响应者和非响应者中.
结论:
- 连续胺注入为TRD提供了潜在的快速起作用的抗抑郁药选择.
- 复发的高发病率和自杀的重大风险需要仔细考虑好处与危害的比率.
- 需要进一步的研究来优化胺治疗方案,并在临床实践中管理相关风险.
相关概念视频
01:30Electroconvulsive Therapy
25
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
25
01:26Psychosis: Goals of Pharmacotherapy
104
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
104
01:03Long-term Depression
2.5K
Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Calcium Ion Concentration Mechanism
If over...
Calcium Ion Concentration Mechanism
If over...
2.5K
01:28Drug Therapy
39
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
39
01:23Antidepressant Drugs: MAOIs and Other Agents
196
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...
196