背景:此更新的目的是添加新批准的命名法和治疗方法以及尚未批准的重度抑郁症治疗方法,从而扩大了将耐药因素纳入临床方法的讨论。
方法:与基于RAND/UCLA适当性方法的第一个共识指南不同,法国生物精神病学和神经精神药理学协会(AFPBN)更新了部分反应性抑郁症(PRD)和难治性抑郁症(TRD)的治疗指南.专家指南结合了科学证据和专家临床医生的意见,为珠三角和TRD提供建议。
结果:这些建议涉及三个领域,这些领域对于更新先前的2019AFPBNTRD患者管理指南至关重要:(1)识别与TRD相关的风险因素,(2)PRD和TRD患者的治疗管理,和(3)的迹象,最近的谷氨酸受体调节剂(艾氯胺酮和氯胺酮)的使用方式和监测。
结论:这些基于共识的指南可以在现有的经验文献和临床实践之间建立桥梁,以临床实践的“真实世界”为亮点,以TRD专业处方者的经验为中心的务实方法支持。
BACKGROUND: The purpose of this update is to add newly approved nomenclatures and treatments as well as treatments yet to be approved in major depressive disorder, thus expanding the discussions on the integration of resistance factors into the clinical approach.
METHODS: Unlike the first consensus guidelines based on the RAND/UCLA Appropriateness Method, the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) developed an update of these guidelines for the management of partially responsive depression (PRD) and treatment-resistant depression (TRD). The expert guidelines combine scientific evidence and expert clinicians\' opinions to produce recommendations for PRD and TRD.
RESULTS: The recommendations addressed three areas judged as essential for updating the previous 2019 AFPBN guidelines for the management of patients with TRD: (1) the identification of risk factors associated with TRD, (2) the therapeutic management of patients with PRD and TRD, and (3) the indications, the modalities of use and the monitoring of recent glutamate receptor modulating agents (esketamine and ketamine).
CONCLUSIONS: These consensus-based guidelines make it possible to build bridges between the available empirical literature and clinical practice, with a highlight on the \'real world\' of the clinical practice, supported by a pragmatic approach centred on the experience of specialised prescribers in TRD.