Dichter Gabriel S, Tomarken Andrew J, Freid Cathryn M, Addington Stephanie, Shelton Richard C
Department of Psychology, College of Arts and Sciences, Wilson Hall, Vanderbilt University, Nashville TN 37203, USA.
J Affect Disord. 2005 Apr;85(3):333-9. doi: 10.1016/j.jad.2004.10.007.
We assessed the therapeutic effects of venlafaxine XR and paroxetine on mood and anxiety symptoms derived from the tripartite model of mood. We hypothesized that the two antidepressants would have largely similar effects on symptoms of negative affect because both agents influence serotonergic systems. However, based on evidence indicating linkages between catecholaminergic activity and the emotional dimension of positive affect, we hypothesized that the catecholaminergic effects of venlafaxine XR would yield particularly pronounced effects on symptoms of positive affect.
Twenty depressed outpatients were randomly assigned to treatment with either venlafaxine XR (225 mg/day) or paroxetine (30 mg/day) during a 12-week treatment trial. Weekly mood ratings were collected using the Mood and Anxiety Symptom Questionnaire [Watson, D., Clark, L.A., Weber, K., Assenheimer, J.S., Strauss, M.E., McCormick, R.A., 1995. Testing a tripartite model: II. Exploring the symptom structure of anxiety and depression in student, adult, and patient samples. J. Abnorm. Psychol. 104 (1), 15-25] [Watson, D., Weber, K., Assenheimer, J.S., Clark, L.A., Strauss, M.E., McCormick, R.A., 1995. Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. J. Abnorm. Psychol. 104 (1), 3-14].
Consistent with predictions, analyses revealed that there were no significant differences between venlafaxine XR and paroxetine on measures of negative affect. However, contrary to predictions, the two medications produced similar changes on measures of positive affect.
Replication and extension using a larger sample size are mandated.
These preliminary results suggest that two antidepressants that appear to have dissimilar mechanisms of action may nevertheless have similar effects on the positive and negative affective components of depression. Alternatively, paroxetine may have a clinically relevant noradrenergic effect at the dose tested.
我们评估了文拉法辛缓释片和帕罗西汀对源自情绪三方模型的情绪和焦虑症状的治疗效果。我们假设这两种抗抑郁药对消极情绪症状的影响在很大程度上相似，因为这两种药物都影响血清素能系统。然而，基于表明儿茶酚胺能活性与积极情绪维度之间存在联系的证据，我们假设文拉法辛缓释片的儿茶酚胺能作用会对积极情绪症状产生特别显著的影响。
20名抑郁症门诊患者在为期12周的治疗试验中被随机分配接受文拉法辛缓释片（225毫克/天）或帕罗西汀（30毫克/天）治疗。使用《情绪与焦虑症状问卷》[沃森，D.，克拉克，L.A.，韦伯，K.，阿森海默，J.S.，施特劳斯，M.E.，麦科米克，R.A.，1995年。检验三方模型：II。探索学生、成人和患者样本中焦虑和抑郁的症状结构。《变态心理学杂志》104(1)，15 - 25][沃森，D.，韦伯，K.，阿森海默，J.S.，克拉克，L.A.，施特劳斯，M.E.，麦科米克，R.A.，1995年。检验三方模型：I。评估焦虑和抑郁症状量表的收敛效度和区分效度。《变态心理学杂志》104(1)，3 - 14]每周收集情绪评分。
与预测一致，分析显示文拉法辛缓释片和帕罗西汀在消极情绪测量方面没有显著差异。然而，与预测相反，这两种药物在积极情绪测量方面产生了相似的变化。
必须使用更大样本量进行重复和扩展研究。
这些初步结果表明，两种作用机制看似不同的抗抑郁药可能对抑郁症的积极和消极情感成分产生相似的影响。或者，帕罗西汀在测试剂量下可能具有临床相关的去甲肾上腺素能作用。
