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全球首款产后抑郁药Zulresso在美问世 获美国FDA批准 售价高达7450美元

转载来源:观察者网 发布日期:2019年03月22日 孕产护理

近年来,由产后抑郁症引发的悲剧时常出现在公众视野中,但仍未得到足够的重视。不少患上产后抑郁症的妈妈们,时常被亲人误认为“矫情”,靠着一句“为母则刚”度过病程。

昨日,美国食品药品管理局(FDA)批准了史上首款专门针对产后抑郁症的新药。这再度引发国内社交平台上中国妈妈们对产后抑郁话题的讨论。有网友为之点赞,产后抑郁这个全球女性的问题,终于开始得到重视。

不过,虽然此药药效快,但网友看到价格后表示“更抑郁了”。也有网友换个角度:有愿意为自己花巨资治病的家人,这样的妈妈很少会有抑郁症。而据记者了解,国内一些新晋妈妈所得产后抑郁(或障碍),很可能是产后家庭矛盾等外部因素引起,并非生理本身。

药效快,但一个疗程34000美元

FDA网站介绍,该机构此次批准的是美国SAGE Therapeutics公司研发的抗产后抑郁症药物Zulresso(又名brexanolone)。此药将在经过风险评估和缓解策略认证(REMS)的医疗机构中由合格的医护人员,经过静脉注射方式给患者服用。

此药的优点在于“药效快”。

SAGE公司发布的研究报告指出,患者服用Zulresso“数日”后,其抑郁症状获很大改善?!杜υ际北ā繁ǖ莱?,患者使用该药48小时,中到重度抑郁就会开始缓解。

而此药问世前,产后抑郁症患者必须服用其他抗抑郁药,需连续吃2-4周才开始见效。

此外,Zulresso很少会进入母乳,患者在服用吃药后几天内就能恢复母乳喂养。

但这款药物的缺点也是很明显的:贵!

SAGE网站介绍,每瓶Zulresso零售价格7450美元,每个疗程相当于34000美元。此药目前还未上市,相关医保优惠不明。

其次,一个疗程所需时间为2.5天,患者必须无间断连续点滴60个小时。过程中患者可能产生嗜睡,甚至晕厥等反应,需要医护人员陪同。需要注意的是,SAGE公司强调,输液过程中患者不能单独和孩子在一起,需要有人陪伴。

最主要的问题,是此药的药效时长不明。

SAGE公司当初在2016年和2017年间对药品进行测试时,对超过200名服用过Zulresso的患者,进行了为期30天的跟踪,结果发现,有94%的患者并没有复发产后抑郁症。对此,该公司表示,“此药一次服用,30天内有效”。

但产后抑郁症并不是不会复发。

国家二级心理咨询师孙嘉仪,曾于2017年1月接受澎湃新闻采访时透露,“产后抑郁症有其时间诊断标准——产后六个月内首次发病,在临床上有不少女性,产前就有抑郁隐患,但是因为怀孕了无法服药而导致产后抑郁症加重。对于产前从无抑郁症病史,单纯性的产后遗症患者,我们通?;岫云浣行形现系恼嬉?,一般在产后抑郁患者在发病3至6个月内会自愈,极少数患者病情会持续1至2年,再次妊娠,有20%~30%的复发率?!?/p>

“有家人愿意出34000美元,

这样的人很少得抑郁症”

这则消息一出,在微博上引起不小轰动。微博认证果壳网主笔@游识猷在权衡此药的利和弊后认为,不管如何,终于开始有了专门针对产后抑郁的药物。

也有网友回想当初的产后生活,很想回去帮帮自己?!八淙缓芄?,但很欣慰,终于有产后抗抑郁药了?!?/p>

随即有网友表示,新晋妈妈可能2天半不用管孩子,或者让孩子他爹分摊一半责任,抑郁症就会好一点。

还有人觉得,看到药效很想给自己来一针,但看到价格更抑郁了。随即有观点指出,有家里人愿意出这34000美元,有这样人很少会得产后抑郁症。

的确,产后抑郁症并非只是母体体内激素水平剧烈变化后所产生的症状。

孙嘉怡曾指出,孩子出生后的半年内,往往是家庭矛盾高发期。围绕孩子的吃喝拉撒、不同育儿观念等分歧矛盾都可能会引发家庭大战。此时,丈夫和家人对产妇的关心理解尤为重要。

2017年1月6日,湖南省湘潭市某小区, 一位年仅31岁的妈妈写完一封遗书,带着两岁多的儿子和几个月大的女儿从13楼纵身跃下,送医后不治身亡。遗书中提到,在忍受长达22个小时分娩痛苦后,在刚生完孩子的第一天,毫无医学常识的老公当众质问她是不是有性病。

“产后抑郁不仅仅事关产妇一个人的问题,其丈夫和家人也需要掌握相关知识懂得如何面对?!彼锛吴硎?,“同样的,对于产后抑郁的患者,丈夫和家人的知识储备和积极引导是至关重要的?!?/p>

“为母则刚”凭什么?

产后抑郁这个概念在国内仍未得到足够的重视。

我国尚无针对产后抑郁障碍的诊断标准。国内医疗咨询机构“丁香园”则在2017年4月指出,根据美国精神病学会(APA)DSM-5重度障碍诊断标准来看,新晋妈妈在过去两周内,经?;蚣负趺刻斐鱿窒铝?条或以上症状,即可判断为产后抑郁障碍。

此外,国内目前尚无针对这类抑郁发病情况的大规模流行病学调查结果,只有一些小规模地区性的调研,而且数据差异巨大?!岸∠阋缴鄙显碌自?014年《产后抑郁防治指南的专家共识》的一组数据:

“我国的患病率为 1.1%-52.1%,平均 14.7%,与目前国际上比较公认的10%-15%的患病率基本一致?!?/p>

最后,如今我国只有北上深及其他发达地区的少数医院,在以试点的形式进行着产后抑郁的筛查和干预?!岸∠阍啊比衔?,随着“二胎政策”全面开放,也许会与之相伴的产后抑郁复发也会变得形势严峻。

就在1个月前(2月24日),南宁安阳路某小区居民楼发生一起坠楼事件:一对母子相继从小区31层楼坠楼,25岁的母亲当场死亡,四岁小男孩送医抢救无效死亡。

事后,有居民通过微信朋友圈透露,这位年轻妈妈患有严重的产后抑郁症。事发当天,夫妻曾因故发生争吵,母亲在将小孩丢下楼后,自己也跟着跳下去。

这起事件在两会期间引起人大代表高度关注。

据文汇报消息,全国人大代表、2016年全国五一奖章获得者丁小兵建议,在中学课本中增加抑郁症防治内容,普及抑郁症知识。

他说:“如果当时这位丈夫知道产后抑郁的危害性,知道如何防治、照顾抑郁症患者的话,我想这个悲剧是可以避免的。我建议在中学健康课本中增加抑郁症的防治内容,从小抓起,普及人们对抑郁症的知识?!?/p>

网友评论

依依是只兔子

  • (游客) 18小时前

回复主题:女子花16万住月子中心孩子右股骨干骨折

记得女儿出生不久,她奶奶就双手压孩子双腿,像擀面一样。说这样做能防止孩子欧型腿之类,湖北话叫擀长长。你们说孩子会不会也被这样按摩(力度大),才导致大腿骨折的?

草根兄弟

  • (游客) 18小时前

回复主题:女子花16万住月子中心孩子右股骨干骨折

有钱,烧的,谁家的孩子不是自己看护,把这么小的孩子给别人看,做父母的也放心,你不就是想轻松一下么,但是你失去的是养孩子的乐趣,就跟溥仪一样长大了跟谁最近,跟没有血缘关系的奶妈?。?!

摄影师

  • (游客) 2天前

回复主题:东莞等多地公办(集体办)幼儿园酝酿涨价 普惠教育面临成本难题

我来算算幼儿园有多挣钱,比如某个地方的一个幼儿园,大班一个班50~60人,一个老师一个保育员,老师工资2800 保育员2200 班上最少50人,孩子一个月880保健费,还有乱七八糟的费。老板私立幼儿园,租的房子一年貌似30w 基本上一个幼儿园保持在180个生源,来算开账。

喵儿喵喵喵喵

  • (游客) 2天前

回复主题:东莞等多地公办(集体办)幼儿园酝酿涨价 普惠教育面临成本难题

现在幼儿园确实读不起啊,按照我们这里为例,如果是农村就义务教育,压力还算很轻,一学期就千把块,但是书全部都是自己买,学?;峥プ?,让家长去买书。如果是城市,作为农村人要先买房,然后根据区域分配去读书,一般的公立在8500左右一学期,私立根据各个学校不同收费,上万的样子一学期。

余生再见不相识

  • (游客) 2天前

回复主题:五部门联合发文治理校闹,明确8种“校闹”行为,在学校拉横幅、摆花圈或受处罚

仔细看看全文,最后一句非常有意思:师生、家长或校外人员以其他原因在校内非法聚集,游行等参照上述规定处理,这个应用场景广泛了??!无论什么事学生集会游行,都可以扣上这顶帽子 也难怪,有些人当年不就靠发动学生来成事的吗?同样的错误自己怎么能犯?

忙碌小琪

  • (游客) 4天前

回复主题:安徽铜陵市教师周安员师生冲突后崩溃投江自杀,教师家属打算起诉学生家长,谁该为这起悲剧负责?

怎么说呢?社会上很多关于老师的新闻,老师如果真的做错了,整个教育局带着老师去给人家赔礼道歉,这个我没意见,这就应该的??赏蛞灰羌页ご砹四??不见得有警察押着家长给老师赔礼道歉。现在的老师们大多当得憋屈。如果有关机构能够在老师受委屈时站出来维护老师,老师也不至于寻短见。

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