Rush A J, Batey S R, Donahue R M, Ascher J A, Carmody T J, Metz A
Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9086, USA.
J Affect Disord. 2001 Apr;64(1):81-7. doi: 10.1016/s0165-0327(00)00250-0.
A common clinical belief is that more sedating and/or serotonin-selective antidepressants are preferred for depressed patients with symptoms of anxiety compared with more activating and/or catecholamine-selective antidepressants. The purpose of this study was to determine whether higher baseline anxiety is associated with different antidepressant responses to bupropion sustained release (SR) or sertraline.
A retrospective data analysis was conducted using pooled data from two identical 8-week, randomized, double-blind, placebo-controlled multicenter studies of bupropion SR (n=234), sertraline (n=225), and placebo (n=233) in adult outpatients with recurrent, major depressive disorder. Anxiety symptoms were measured using the 14-item Hamilton Anxiety Rating Scale scores.
Baseline anxiety levels were not related to antidepressant response to treatment with either bupropion SR or sertraline, nor did they differentiate between responders to bupropion SR and responders to sertraline.
Baseline anxiety levels do not appear to be a basis for selecting between bupropion SR and sertraline in the treatment of outpatients with major depressive disorder.
一种常见的临床观点认为,与更具激活作用和/或儿茶酚胺选择性的抗抑郁药相比,更具镇静作用和/或血清素选择性的抗抑郁药更适合用于伴有焦虑症状的抑郁症患者。本研究的目的是确定较高的基线焦虑水平是否与对安非他酮缓释片(SR)或舍曲林的不同抗抑郁反应相关。
使用来自两项相同的为期8周的随机、双盲、安慰剂对照多中心研究的汇总数据进行回顾性数据分析,这两项研究分别针对患有复发性重度抑郁症的成年门诊患者使用安非他酮SR(n = 234)、舍曲林(n = 225)和安慰剂(n = 233)。使用14项汉密尔顿焦虑量表评分来测量焦虑症状。
基线焦虑水平与对安非他酮SR或舍曲林治疗的抗抑郁反应无关,也不能区分安非他酮SR的反应者和舍曲林的反应者。
在治疗重度抑郁症门诊患者时,基线焦虑水平似乎不是在安非他酮SR和舍曲林之间进行选择的依据。