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成人双相障碍：应用抗抑郁药治疗重度抑郁

Authors
William V Bobo, MD, MPH
Richard C Shelton, MD
Section Editor
Paul Keck, MD
Deputy Editor
David Solomon, MD
Translators
王强, 副教授

引言

抗抑郁药用于双相抑郁急性期和维持期的治疗尚存争议，因为担心这些药物无效且可能使患者从抑郁型转为躁狂型和快速循环型障碍从而危害患者[1-3]。然而，抗抑郁药(表 1)是双相抑郁最常开具的药物。在美国(n=7760)[4]和欧洲(n=2231)[5]进行的针对双相障碍患者的研究发现，分别有50%和81%的患者被开具了抗抑郁药处方，但这可能部分是由其他治疗疗效有限或耐受性差所致[6]。

本专题将总结抗抑郁药对双相重度抑郁患者的疗效及这类药物导致转相的风险；快速循环型的风险将单独讨论。针对双相重度抑郁、躁狂和轻躁狂的药物方案选择以及双相障碍的维持期治疗也将单独讨论。

●(参见“快速循环型双相障碍：流行病学、发病机制、临床特征与诊断”，关于‘抗抑郁药’一节)

●(参见“成人双相障碍：急性抑郁症的药物治疗”)

●(参见“成人双相障碍：急性躁狂和轻躁狂的药物治疗”)

                        

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Literature review current through: 2017-07 . | This topic last updated: 2016-07-13.
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