难治性

善，通常被称为难治性抑郁症,难治性抑郁症具有复发率高、致残率高和生活质量低等特点，给患者带来痛苦，给社会和家属带来极大的负担[1]。目前，难治性抑郁症的病理机制尚不明确。研究发现抑郁症患者下丘脑-垂体-肾上腺皮质（hypothalamic-pituitary-adrenocortical，HPA）系统存在功能亢进，而下丘脑-垂体-甲状腺（hypothalamic-pituitary-thyroid–adrenocortical，HPT）系统功能低下，主要表

nner DL难治性抑郁症; 抗抑郁药替换; 抗抑郁药联合治疗; 增效Summary:Treatment-resistant depression is a common problem encountered by psychiatrists. These patients are often difficult to treat effectively. Strategies for addressing patients with treatment