Papakostas George I, Petersen Timothy, Lebowitz Barry D, Mischoulon David, Ryan Julie L, Nierenberg Andrew A, Bottiglieri Teodoro, Alpert Jonathan E, Rosenbaum Jerrold F, Fava Maurizio
Department of Psychiatry, Depression Clinical and Research Program, Massachusetts General Hospital Harvard Medical School, Boston, MA 02114, USA.
Int J Neuropsychopharmacol. 2005 Dec;8(4):523-8. doi: 10.1017/S1461145705005195. Epub 2005 May 9.
The objective of the present study was to examine the relationship between serum folate, vitamin B12, and homocysteine levels and the timing of clinical improvement to fluoxetine in major depressive disorder (MDD) patients. A total of 110 outpatients with MDD who responded to an 8-wk trial of fluoxetine had serum folate, B12, and homocysteine measurements at baseline (prior to fluoxetine initiation). Onset of clinical improvement was defined as a 30% decrease in Hamilton Depression Scale scores that led to a 50% decrease by week 8. Patients with low folate levels (<or=2.5 ng/ml) were more likely to experience a later onset of clinical improvement than eufolatemic patients ( p =0.0028). B12 and homocysteine level status did not predict time to clinical improvement ( p >0.05). In conclusion, low serum folate levels were found to be associated with a delayed onset of clinical improvement during treatment with fluoxetine in MDD by, on average, 1.5 wk.
本研究的目的是探讨血清叶酸、维生素B12和同型半胱氨酸水平与重度抑郁症（MDD）患者接受氟西汀治疗后临床改善时间之间的关系。共有110例对氟西汀8周试验有反应的MDD门诊患者在基线时（开始使用氟西汀之前）进行了血清叶酸、维生素B12和同型半胱氨酸检测。临床改善的开始定义为汉密尔顿抑郁量表评分下降30%，并在第8周时下降50%。叶酸水平低（≤2.5 ng/ml）的患者比叶酸水平正常的患者更有可能出现较晚的临床改善（p = 0.0028）。维生素B12和同型半胱氨酸水平状态不能预测临床改善时间（p > 0.05）。总之，研究发现血清叶酸水平低与MDD患者在接受氟西汀治疗期间临床改善延迟有关，平均延迟1.5周。
