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在没有抑郁迹象的养老院老年患者中选择性5-羟色胺再摄取抑制剂药物的控制性撤药

Controlled withdrawal of selective serotonin reuptake inhibitor drugs in elderly patients in nursing homes with no indication of depression.

作者信息

Ulfvarson Johanna, Adami Johanna, Wredling Regina, Kjellman Bengt, Reilly Marie, von Bahr Christer

机构信息

Division of Clinical Pharmacology, Stockholm South General Hospital, 11883, Stockholm, Sweden.

出版信息

Eur J Clin Pharmacol. 2003 Dec;59(10):735-40. doi: 10.1007/s00228-003-0687-y. Epub 2003 Nov 1.

Abstract

OBJECTIVE

The aim of the investigation was to study the effects of withdrawing selective serotonin reuptake inhibitor (SSRI) drugs in nursing home patients, who had no documented diagnosis or symptoms of depression.

SETTING

The setting of the study was in 11 nursing homes in the county of Stockholm, Sweden.

PARTICIPANTS

Participants were patients without dementia or history of depression who had received treatment with SSRI drugs for more than 6 months and who had no indications of anxiety disorder or major depression

DESIGN

The included patients ( n=70) were randomized to either the intervention group (withdrawal of SSRI) or the control group (no change in treatment), 35 patients to each group.

MAIN OUTCOME MEASURES

The patients were subjected to assessment using the following instruments: Montgomery-Asberg depression rating scale, global assessment for functioning, health index and a symptom assessment form. Assessment was made at the start of the study and at the 3-month and 6-month follow-ups.

RESULTS

We found no significant difference between the intervention and control groups in any outcome measure.

CONCLUSION

Treatment with SSRI drugs in patients without clinical major depression or anxiety disorder is often unjustified and should be discontinued.

摘要

目的

本调查旨在研究在没有抑郁症确诊记录或症状的疗养院患者中停用选择性5-羟色胺再摄取抑制剂(SSRI)药物的效果。

设置

研究地点为瑞典斯德哥尔摩县的11家疗养院。

参与者

参与者为无痴呆症或抑郁症病史、接受SSRI药物治疗超过6个月且无焦虑症或重度抑郁症迹象的患者。

设计

纳入的患者(n = 70)被随机分为干预组(停用SSRI)或对照组(治疗不变),每组35名患者。

主要结局指标

使用以下工具对患者进行评估:蒙哥马利-阿斯伯格抑郁评定量表、功能总体评估、健康指数和症状评估表。在研究开始时以及3个月和6个月随访时进行评估。

结果

我们发现干预组和对照组在任何结局指标上均无显著差异。

结论

在没有临床重度抑郁症或焦虑症的患者中使用SSRI药物治疗通常不合理,应停药。

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