抑郁症的个体化策略:对伏替西汀有反应的临床概况回顾。

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2024-05-16 DOI:10.1186/s12991-024-00505-1
Alessandro Cuomo, Andrea Aguglia, Domenico De Berardis, Antonio Ventriglio, Camilla Gesi, Andrea Fagiolini
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引用次数: 0

摘要

背景:抑郁症是一种高度异质性的疾病,常常导致不理想的反应和缓解率。这突出表明,需要对患者进行更细致的临床特征描述,以制定个性化的治疗方案。新出现的证据强调了认知和情感功能障碍在重度抑郁症中的关键作用,促使人们探索针对这些特定症状领域的新型治疗干预措施:伏替西汀是一种多模式抗抑郁药,在增强血清素能活性的同时,还能调节其他几种参与抑郁症状(如情感迟钝、失乐症和认知功能障碍)的神经递质系统。大量随机、安慰剂对照试验证明了伏替西汀治疗抑郁症的有效性和安全性,尤其是对特定亚组抑郁症患者,包括有认知障碍和合并焦虑症状或焦虑症的患者。虽然不是随机或安慰剂对照,但研究也显示伏替西汀对情感迟钝或失神的抑郁症患者有疗效。伏替西汀能够有效治疗一系列抑郁症状,包括失神、情感迟钝、焦虑和认知功能障碍,为患有这些症状的抑郁症患者提供了个性化的治疗方案。本文旨在确定可能从伏替西汀中获益的患者的临床特征,从而达到优化治疗效果的目的:事实证明,伏替西汀对患有抑郁症并伴有失神、情感迟钝、焦虑和认知功能障碍等症状的患者有效。根据抑郁症患者表现出的具体症状,因人而异地制定治疗计划和个性化治疗选择,可提高治疗效果。
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Individualized strategies for depression: narrative review of clinical profiles responsive to vortioxetine.

Background: Depression is a highly heterogeneous disorder, often resulting in suboptimal response and remission rates. This underscores the need for more nuanced clinical characterization of patients to tailor individualized treatment plans. Emerging evidence highlights the critical role of cognitive and emotional dysfunction in major depression, prompting the exploration of novel therapeutic interventions that target these specific symptom domains.

Main text: Vortioxetine, a multimodal antidepressant, enhances serotonergic activity while also modulating several other neurotransmitter systems involved in depressive symptoms such as emotional blunting, anhedonia, and cognitive dysfunction. Numerous randomized, placebo-controlled trials have demonstrated vortioxetine's efficacy and safety in treating depression, particularly in specific subgroups of depressed patients, including those with cognitive deficits and comorbid anxiety symptoms or disorders. Although not randomized or placebo-controlled, studies have also shown vortioxetine's efficacy in depressed patients with emotional blunting or anhedonia. Vortioxetine's ability to effectively treat a range of depressive symptoms, including anhedonia, emotional blunting, anxiety, and cognitive dysfunction, provides an individualized treatment solution for depressed individuals suffering from these symptoms. The purpose of this paper is to identify clinical profiles of patients who may benefit from vortioxetine, with the goal of optimizing therapeutic outcomes.

Conclusion: Vortioxetine has been shown to be effective for patients with depression and symptoms such as anhedonia, emotional blunting, anxiety, and cognitive dysfunction. Tailoring treatment plans to individual needs and personalizing treatment choices based on the specific symptoms presented by depressed patients improve treatment outcomes.

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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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