Möslinger-Gehmayr R, Zaninelli R, Contu A, Oberhoff C, Gutschow K, Schindler A E, Staab H J
AKH Wien.
Zentralbl Gynakol. 2000;122(4):195-202.
In this double-blind, non-placebo controlled study [corrected], 179 patients with treated breast cancer who fulfilled the ICD-10 criteria for an acute depressive episode underwent an 8-week course of antidepressant treatment with either the tricyclic amitriptyline (75-150 mg, n = 87) or the serotonin-reuptake inhibitor paroxetine (20-40 mg, n = 88).
The change in clinical status relative to baseline was measured with the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impression (CGI), the Functional Living Index-Cancer (FLIC) and the Patient Global Evaluation.
Both treatment groups showed significant improvement in all parameters at weeks 3, 5 and 8. At no time was there a significant difference in the efficacy of the antidepressants used. Adverse events, most of which were transitory, were reported by 53% of the patients in the paroxetine group and 60% in the amitriptyline group. The 8-week treatment was completed by 81% of the paroxetine and 76% of the amitriptyline patients.
The results of this study show that depression in breast-cancer patients can be correctly diagnosed and adequately treated by non-psychiatrists. The treatment with both medications was carried out in dose ranges which correspond to that employed in physically well patients.
在这项双盲、非安慰剂对照研究中,179名符合国际疾病分类第十版(ICD - 10)急性抑郁发作标准的乳腺癌患者接受了为期8周的抗抑郁治疗,治疗药物为三环类药物阿米替林(75 - 150毫克,n = 87)或5-羟色胺再摄取抑制剂帕罗西汀(20 - 40毫克,n = 88)。
采用蒙哥马利 - 阿斯伯格抑郁评定量表(MADRS)、临床总体印象量表(CGI)、癌症功能生活指数(FLIC)和患者总体评估量表来衡量相对于基线的临床状态变化。
两个治疗组在第3周、第5周和第8周时所有参数均有显著改善。所使用的抗抑郁药物疗效在任何时候均无显著差异。帕罗西汀组53%的患者和阿米替林组60%的患者报告了不良事件,其中大多数为短暂性。帕罗西汀组81%的患者和阿米替林组76%的患者完成了为期8周的治疗。
本研究结果表明,非精神科医生能够正确诊断并充分治疗乳腺癌患者的抑郁症。两种药物的治疗剂量范围与身体健康患者所使用的剂量范围一致。