La depressione maggiore resistente: update delle strategie di trattamento farmacologico

Cesario Bellantuono
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Abstract

Introduction

A significant number of depressed patients has a treatment-resistant depression (TRD). Many clinical trials, as well as the STAR-D study, have shown that in major depression the initial response to treatment with an effective antidepressant drug is often unsatisfactory.

Material and methods

The aim of this review is to provide an updated overview of the psychopharmacological options available for the management of TRD.

Results

A number of therapeutic strategies such as switch, combination and augmentation has been assessed in TRD. The most widely used involves a combination between a second generation antipsychotic (SGA) and a serotoninergic antidepressant (SSRI-SNRI).

Conclusions

SGA augmentation is a safe and effective option for the treatment of resistant depression. Thus far quetiapine is the only drug that has been approved for this purpose in Italy.

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增强耐受性抑郁症:更新药物治疗策略
相当数量的抑郁症患者患有难治性抑郁症(TRD)。许多临床试验以及STAR-D研究都表明,在重度抑郁症患者中,使用有效的抗抑郁药物治疗的最初反应往往不令人满意。材料和方法本综述的目的是提供可用于治疗TRD的精神药理学选择的最新概述。结果对TRD进行了切换、联合、强化等多种治疗策略的评价。最广泛使用的是第二代抗精神病药(SGA)和5 -羟色胺能抗抑郁药(SSRI-SNRI)的结合。结论ssga增强术是治疗难治性抑郁症的一种安全有效的方法。到目前为止,奎硫平是意大利唯一批准用于这一目的的药物。
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