摘要
目的为临床选择妊娠期及产后抑郁症的药物治疗方案提供参考。方法搜索妊娠期及产后抑郁症的药物治疗相关文献,归纳相关治疗方案及建议。结果西酞普兰和舍曲林可用于治疗妊娠期抑郁症;帕罗西汀或氟西汀可能会增加心血管畸形的风险,应避免使用;帕罗西汀和舍曲林可用于母乳喂养,氟西汀和西酞普兰等应避免使用;对选择性5-羟色胺再摄取抑制剂治疗无效或不耐受的患者可考虑使用三环类抗抑郁药,如去甲替林、阿米替林和氯丙咪嗪。结论妊娠期和产后药物的选用需进行个体化分析,建议使用最低有效剂量,此外应权衡治疗药物的利弊与治疗不充分的抑郁症带来的风险。
Objective To provide a reference for the selection of drug treatment for pregnancy and postpartum depression in the clinic.Methods The relevant literature on the drug treatment of pregnancy and postpartum depression was searched,and the relevant treatment schemes and suggestions were summarized.Results Citalopram and sertraline can be used to treat depression during pregnancy.Paroxetine or fluoxetine may increase the risk of cardiovascular malformation and should be avoided.Paroxetine and sertraline can be used for patients who are breast-feeding,while fluoxetine and citalopram should be avoided.Tricyclic antidepressants(TCA)such as nortriptyline,amitriptyline and clomipramine should be considered for patients who are ineffective or intolerant to selective serotonin reuptake inhibitors(SSRI).Conclusion The selection of drugs for patients with pregnancy and postpartum depression needs individualized analysis.It is suggested to use the lowest effective dose.In addition,the advantages and disadvantages of therapeutic drugs should be weighed against the risks of undertreated depression for women and unborn children.
作者
沈俊
王甲
梅洪梁
王羽
SHEN Jun;WANG Jia;MEI Hongliang;WANG Yu(Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing,Jiangsu,China 210008)
出处
《中国药业》
CAS
2022年第4期128-128,I0001,I0002,I0003,共4页
China Pharmaceuticals
基金
中国药学会科技开发中心科普项目[CMEI2020KPYJ(ZAMM)00106]。
