老年人停用抗抑郁药:文献综述。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
ACS Applied Bio Materials Pub Date : 2023-03-28 eCollection Date: 2023-01-01 DOI:10.2147/TCRM.S395449
Ahmed Romdhani, Stephanie Lehmann, Joël Schlatter
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引用次数: 0

摘要

多种药物治疗会增加老年患者出现难以承受的副作用、药物间相互作用和住院治疗的风险。在这一人群中,抗抑郁药管理不当的先天性风险非常重要。因此,初级保健医生和老年病医生有责任优化抗抑郁药的处方。我们的工作是对有关抗抑郁药管理的欧洲和国际指南进行文献综述。我们查阅了 PubMed 数据库和谷歌学者 2015 年以来的文章和评论。我们还筛选了相关文章,以获取更多参考文献,并在网上搜索了与我们的主题相关的欧洲指南。我们将研究结果分为四个主要问题,即适应症、有效性、耐受性和先天性风险。疗效不佳或无效应导致治疗方案的重新调整。如果出现难以忍受的副作用,应停用抗抑郁药物,并建议采用其他非药物疗法。医生应注意这一人群中药物间相互作用的风险,并不断调整处方。抗抑郁药的处方并非总是以证据为基础,这导致了严重的先天性后果。我们提出了一个简单的 4 个问题的算法,旨在提醒医生注意良好操作的基本原则,并帮助医生在给老年人停用抗抑郁药的过程中有所帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Discontinuation of Antidepressants in Older Adults: A Literature Review.

Discontinuation of Antidepressants in Older Adults: A Literature Review.

Polypharmacy increases the risk of unbearable side effects, drug-drug interactions, and hospitalizations in geriatric patients. The iatrogenic risk of inadequate management of antidepressants is very important in this population. Therefore, primary care physicians and geriatricians have the responsibility of the optimization of antidepressants prescriptions. Our work is a literature review of the European and the international guidelines regarding the management of antidepressants. We reviewed the PubMed database and Google scholar for articles and reviews from 2015. We also screened relevant articles for more references and searched the web for available European guidelines relevant to our topic. We divided our findings into four main inquiries that are Indication, effectiveness, tolerability, and iatrogenic risks. Poor or absence of effectiveness should lead to a readjustment of the treatment plan. In case of unbearable side effects, antidepressants should be stopped, and alternative non-pharmacological therapies should be proposed. Doctors should look out for drug-drug interaction risks in this population and constantly adjust the prescription. Prescription of antidepressants is not always evidence based which leads to heavy iatrogenic consequences. We suggest a simple 4-questions-algorithm that aims to remind doctors of the basics of good practice and helps in the process of deprescribing an antidepressant in older adults.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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