Gülseren Leyla, Gülseren Seref, Hekimsoy Zeliha, Mete Levent
Department of Psychiatry, Atatürk Training and Research Hospital, Izmir, Turkey.
Arch Med Res. 2005 Mar-Apr;36(2):159-65. doi: 10.1016/j.arcmed.2004.12.018.
This study aims to investigate the efficacy of fluoxetine and paroxetine on the levels of depression-anxiety, quality of life, disability, and metabolic control in type II diabetes mellitus (DM) patients.
The patients were first applied the Hospital Anxiety-Depression Scale (HADS). After a psychiatric interview with patients who had scores above the cut-off point, those who were diagnosed as having a major depressive disorder according to DSM-IV criteria were applied the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Twenty three patients who scored 16 or above on the HDRS were included in the study and given the Short Form-36 (SF-36), and the Brief Disability Questionnaire (BDQ) and HbA1c levels were measured. Patients were randomized on 20 mg/day fluoxetine or 20 mg/day paroxetine treatment. The patients were evaluated with the same scales at the 2(nd), 4(th), 6(th), and the 12(th) weeks.
Both groups showed a statistically significant decrease in HDRS, HARS, and BDQ scores with comparison to the index assessment. At the end of treatment, though not statistically significant, a decrease was observed in HbA1c values of the fluoxetine-administered group.
Fluoxetine and paroxetine effectively reduce the severity of major depressive disorder in type II DM patients. There is need for further and longer-lasting monitoring studies with more patients in order to determine whether there is any difference in terms of their effects on glycemic control.
本研究旨在调查氟西汀和帕罗西汀对II型糖尿病(DM)患者抑郁焦虑水平、生活质量、残疾状况及代谢控制的疗效。
首先对患者应用医院焦虑抑郁量表(HADS)。对得分高于临界值的患者进行精神科访谈后,根据DSM-IV标准被诊断为重度抑郁症的患者应用汉密尔顿抑郁量表(HDRS)和汉密尔顿焦虑量表(HARS)。将23例HDRS得分16分及以上的患者纳入研究,给予简短健康调查量表(SF-36),并测量简易残疾问卷(BDQ)和糖化血红蛋白(HbA1c)水平。患者被随机分为接受20mg/天氟西汀或20mg/天帕罗西汀治疗。在第2、4、6和12周时用相同量表对患者进行评估。
与初始评估相比,两组患者的HDRS、HARS和BDQ评分均有统计学意义的下降。治疗结束时,氟西汀治疗组的HbA1c值虽无统计学意义,但有所下降。
氟西汀和帕罗西汀可有效降低II型糖尿病患者重度抑郁症的严重程度。为确定它们对血糖控制的影响是否存在差异,需要对更多患者进行进一步的长期监测研究。