Penggantian (switching) dari satu obat antidepresan ke antidepresan lainnya umum dilakukan pada praktik sehari-hari sehingga klinisi harus memahami bagaimana cara mengganti antidepresan secara aman.
Prognosis dari suatu gangguan seperti depresi dan depresi post partum dapat dipengaruhi oleh ketepatan dan efektivitas terapi. Respons terapi merupakan salah satu parameter terhadap efektivitas terapi antidepresan dan indikator penerusan ataupun penggantian (switching) antidepresan dalam kelas yang sama maupun kelas yang berbeda.[1–4]
Saat ini terdapat beberapa kelas antidepresan, seperti Monoamine Oxidase Inhibitors (MAOI), Tricyclic Antidepressant (TCA), Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin Norepinephrine Reuptake Inhibitors (SNRI), Serotonin Partial Agonist/Reuptake Inhibitors (SARIs), Norepinephrine and dopamine reuptake inhibitors (NDRIs), Selective norepinephrine reuptake inhibitors (NRIs), Noradrenaline and specific Serotonergic Antidepressants (NASSA), Agomelatine, dan Vortioxetine (Serotonin Modulator).[1,3–6]
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Referensi
1. Kristin K. Soreide KMW. Strategies and Solutions for Switching Antidepressant Medications [Internet]. Psychiatric Times. 2017 [cited 2019 Oct 21]. Available from: https://www.psychiatrictimes.com/strategies-and-solutions-switching-antidepressant-medications
2. Kudlow PA, McIntyre RS, Lam RW. Early Switching Strategies in Antidepressant Non-Responders: Current Evidence and Future Research Directions. CNS Drugs. 2014 Jul 1;28(7):601–9.
3. Keks N, Hope J, Keogh S. Switching and stopping antidepressants. Aust Prescr. 2016 Jun;39(3):76–83.
4. Sidney H. Kennedy, Raymond W. Lam, Roger S. McIntyre, S. Vale ́rie Tourjman, Venkat Bhat, Pierre Blier, et al. Canadian Network for Mood and AnxietyTreatments (CANMAT) 2016 ClinicalGuidelines for the Management of Adults with Major Depressive Disorder:Section 3. Pharmacological Treatments. Rev Can Psychiatr [Internet]. 2016;1(21). Available from: https://www.cmh.org/sites/default/files/page-assets/programs-services/mental-health-services/mental-health-events-health-care-providers/canmat-pharmacological-39247.pdf
5. Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms. Ther Adv Psychopharmacol. 2015 Dec;5(6):357–68.
6. withdrawal or changing of antidepressant treatment - General Practice Notebook [Internet]. [cited 2019 Oct 21]. Available from: https://www.gpnotebook.co.uk/simplepage.cfm?ID=1637482568
7. Depression overview - NICE Pathways [Internet]. [cited 2019 Oct 11]. Available from: https://pathways.nice.org.uk/pathways/depression
8. discontinuation syndromes with antidepressants - General Practice Notebook [Internet]. [cited 2019 Oct 21]. Available from: https://www.gpnotebook.co.uk/simplepage.cfm?ID=1664417864&linkID=31821&cook=no
9. Foong A-L, Grindrod KA, Patel T, Kellar J. Demystifying serotonin syndrome (or serotonin toxicity). Can Fam Physician. 2018 Oct;64(10):720–7.
10. Foong A-L, Patel T, Kellar J, Grindrod KA. The scoop on serotonin syndrome. Can Pharm J CPJ. 2018 May 30;151(4):233–9.
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