Tedaviye dirençli tek uçlu depresyonda ilaç seçimini etkileyen etmenler

Tedaviye Dirençli Depresyon (TDD), insanların yaşam kalitesini azaltan yaygın ve malüliyete neden olan bir hastalıktır. Major depresyonlu hastaların üçte ikisi ilk antidepresan tedavisine cevap vermezler. Ancak TDD için uzlaşma sağlanmış bir tanım ve değerlendirme yöntemi henüz geliştirilmemiştir. TDD olarak değerlendirilen hastaların çoğu yanlış tanı veya yetersiz tedavi almışlardır. TDD hastaların ilk değerlendirilmesinde psikiyatrik tanıları ve tıbbi durumu ayrıntılı ele alınmalıdır. TDD tedavisinin düzenlenmesinde üç farmakolojik strateji vardır: antidepresan dozunu optimize etmek; güçlendirme/kombinasyon tedavisi ve ilaç değişikliğidir.

Anahtar Kelimeler:

tedaviye direnç, depresyon, güçlendirme, ilaç kombinasyonu

Factors effecting drug selection for treatment resistant unipolar depression

Treatment Resistant Depression (TRD) is a common and debilitating disease affecting much of people during their lifetime and leads to significant reductions in quality of life. Up to two thirds of patients with major depression will not respond to the first antidepressant medication. However, a clear consensus regarding the criteria defining and assessing method of TRD is not developed yet in the psychiatric community. Many patients who are considered treatment resistant are actually misdiagnosed or inadequately treated. Diagnostic reassessment is the first step during evaluation of patients with treatment-resistant depression and must include examining psychiatric and organic causes of depression. In managing TRD, three pharmacotherapy strategies are in clinical use: optimization of antidepressant dose, augmentation/combination therapies and switching pharmacotherapy.

Keywords:

treatment resistance, depression, augmentation, drug combination,

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