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阿戈美拉汀治疗抑郁症临床应用专家建议 被引量:2

Clinical application recommendation on agomelatine in treatment of major depressive disorder
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摘要 抑郁症具有高患病率、高复发率和疾病负担重等特点,经规范治疗,仍有部分患者疗效欠佳或存在残留症状。阿戈美拉汀作为一种新的抗抑郁药,其作用机制突破了传统单胺递质系统,特异性激动褪黑素受体,同时拮抗5-HT2c受体。由于其独特的作用机制,阿戈美拉汀除了改善抑郁情绪,还具有调节睡眠和生物节律、性功能影响少、耐受性好、不影响体重、撤药反应小等优势。因为阿戈美拉汀潜在肝功能损害的风险,临床使用中需定期监测肝功能,注意与某些药物联用禁忌等问题。本文重点介绍国内外阿戈美拉汀临床应用中的循证证据、用药方法、安全性、临床应用特色、临床相关问题和处理等,结合广大专家的用药经验,为临床医生提供用药参考,从而促进抑郁症患者治疗结局和预后的改善,促进患者回归社会。 Depressive disorder is characterized by high prevalence,high recurrence rate and heavy burden of disease.After standardized treatment,some patients show treatment-resistant or have residual symptoms.Agomelatine,as a new antidepressant,which breaks through the traditional monoamine transmitter system,specifically activates the receptors of melatonin and blocks the receptor of 5-HT2c.Because of its unique mechanism,in addition to improving depression,agomelatine also has the advantages of regulating sleep and circadian rhythms,less sexual dysfunction,good tolerance,no influence on body weight,little withdrawal reaction,etc.However,due to the potential risk of liver damage caused by agomelatine,it is necessary to monitor liver function regularly in clinical use and pay attention to the eontraindication of combination with some drugs.Combined with the experience of experts,this article focused on the evidence-based evidence, medication methods,safety,clinical characteristics,and clinical related problems and treatment of agomelatine,in order to provide reference of usage for clinicians,improve the outcome and prognosis of patients and promote patients return to society.
作者 洪武 司天梅 李凌江 许秀峰 高成阁 栗克清 施剑飞 焦志安 彭代辉 李毅 姚志剑 邱昌建 王惠玲 王艺明 黄继忠 方贻儒 HONG Wu;SI Tian-mei;LI Ling-jiang;XU Xiu-feng;GAO Cheng-ge;LI Ke-qing;SHI Jian-fei;JIAO Zhi-an;PENG Dai-hui;LI Yi;YAO Zhi-jian;QIU Chang-jian;WANG Hui-ling;WANG Yi-ming;HUANG Ji-zhong;FANG Yi-ru(Shanghai Mental Health Center,Shanghai Jiaotong University School of Medicine,SHANGHAI 200030,China;Brain Hospital Affiliated to Nanjing Medical University,Nanjing JIANGSU 210029,China;West China Hospital,Sichuan University,Chengdu SICHUAN 610041,China;Renmin Hospital of Wuhan University,Wuhan HUBEI 430060,China;The Affiliated Hospital of Guizhou Medical University,Guiyang GUIZHOU 550004,China;Shanghai Key Laboratory of Psychotic Disorders,SHANGHAI 201108,China;CAS Center for Excellence in Brain Science and Intelligence Technology,SHANGHAI 200031,China;Institute of Mental Health,Peking University,BEIJING 100191,China;The Second Xiangya Hospital of Central South University,Changsha HU-NAN 410011,China;The First Affiliated Hospital of Kunming Medical University,Kunming YUNNAN 650032,China;The First Affiliated Hospital of Xi-an Jiaotong University,Xi-an SHAANXI 710061,China;The Sixth People's Hospital of Hebei Province,Baoding HEBEI 071000,China;Hangzhou 7th People's Hospital,Hangzhou ZHEJIANG 310013,China;Shandong Provincial Hospital,Ji-nan SHANDONG 250021,China;Wuhan Mental Health Center,Wuhan HUBEI 430022,China)
出处 《中国新药与临床杂志》 CSCD 北大核心 2018年第11期601-607,共7页 Chinese Journal of New Drugs and Clinical Remedies
基金 国家重点研发计划资助项目(2016YFC1307100,2016YFC0906300) 国家自然科学基金项目(81701344,81771465) 上海市卫生和计划生育委员会科研课题项目(201740115).
关键词 阿戈美拉汀 抑郁症 药物疗法 agomelatine depressive disorder drug therapy
作者简介 洪武,女,副主任医师,硕士生导师,博士,主要从事心境障碍的临床和基础研究,E—mail:drhongwu@126.com;责任作者:黄继忠,E-mail:junghjz@vip.sina.com;责任作者:方贻儒,E-mail:yimfang@aliyun.com。
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