治疗耐药性抑郁症和鼻内胺:西班牙对理论方面的共识
Fernando Mora1,2, Jose Antoni Ramos-Quiroga3,4,5,6, Enrique Baca-García7,8,9,10,11,12,13,14
1Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain.
Frontiers in psychiatry
|August 21, 2025
概括
这一西班牙共识定义了耐治疗抑郁症 (TRD),并提出了治疗算法. 它突出了鼻腔内胺
科学领域:
- 神经科学
- 精神病学
- 药理学
背景情况:
- 治疗耐药性抑郁症 (TRD) 对患者产生重大影响,并带来巨大的社会经济负担.
- 缺乏关于TRD定义的共识使有效的患者管理变得复杂.
- 通过增强神经可塑性和协同生成,鼻内胺提供了一种新的治疗方法.
研究的目的:
- 在西班牙建立TRD理论和概念方面的共识.
- 提出TRD和临床反应的明确定义.
- 概述TRD治疗场景中的鼻内胺的作用.
主要方法:
- 一个由十名西班牙TRD专家组成的科学委员会进行了文献审查 (2014-2024年).
- 声明是通过讨论小组开发的,并使用名义小组技术进行了改进.
- 通过起草会议最终达成共识.
主要成果:
- 建立了TRD和临床反应的拟议定义.
- 分析了治疗惯性的影响,包括其原因和后果.
- 开发了TRD的治疗算法,其中包括鼻内胺和反应评估策略.
结论:
- 这标志着西班牙首次就TRD的理论方面和鼻内胺的作用达成共识.
- 开发了TRD的定义和综合治疗算法.
- 这种共识旨在改善TRD管理并减少治疗惯性.
相关概念视频
Electroconvulsive Therapy
185
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...
185
Antidepressant Drugs: MAOIs and Other Agents
344
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...
344
Psychosis: Goals of Pharmacotherapy
209
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.
209
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
568
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...
568
Drug Therapy
97
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
97
Treatment Strategies for Psychological Disorders
267
Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
267


