Use of atypical antipsychotics: observations from clinical practice.

摘要

A psychiatrically well-informed internist colleague recently referred a patient with persistent depression for whom he had prescribed, in a stepwise fashion, a sensible combination of venlafaxine, bu-propion, and risperidone. The antidepres-sants were at reasonable but not quite maximal doses. His question concerning this patient with nonmelancholic, non-psychotic, recurrent unipolar depression: should he increase risperidone further, or push bupropion or venlafaxine? His patient was only mildly anxious, without a distinct anxiety syndrome, and worried, without frank ruminations. His inclination, guided more by clinical experience than anything he had been taught, was to increase risperidone.