Trivedi Madhukar H, Greer Tracy L, Grannemann Bruce D, Chambliss Heather O, Jordan Alexander N
University of Texas Southwestern Medical Center at Dallas, Mood Disorders Research Program and Clinic, 6363 Forest Park, Dallas, TX 75235, USA.
J Psychiatr Pract. 2006 Jul;12(4):205-13. doi: 10.1097/00131746-200607000-00002.
The use of augmentation strategies among patients with major depression is increasing because rates of complete remission with standard antidepressant monotherapy are quite low. Clinical and neurobiological data suggest that exercise may be a good candidate for use as an augmentation treatment for depression. This pilot study examined the use of exercise to augment antidepressant medication in patients with major depression. Seventeen patients with incomplete remission of depressive symptoms began a 12-week exercise program while continuing their antidepressant medication (unchanged in type or dose). Individual exercise prescriptions were calculated based on an exercise dose consistent with currently recommended public health guidelines. The exercise consisted of both supervised and home-based sessions. The 17-item Hamilton Rating Scale for Depression (HRSD17) and the Inventory of Depressive Symptomatology-Self-Report (IDS-SR30) were used to assess symptoms of depression on a weekly basis. Intent-to-treat analyses yielded significant decreases on both the HRSD17 (5.8 points, p < 0.008) and IDS-SR30 (13.9 points, p < 0.002). For patients who completed the study (n = 8), HRSD17 scores decreased by 10.4 points and IDS-SR30 scores decreased by 18.8 points. This study provides preliminary evidence for exercise as an effective augmentation treatment for antidepressant medication. This is a lower-cost augmentation strategy that has numerous health benefits and may further reduce depressive symptoms in partial responders to antidepressant treatment. Practical tips on how practitioners can use exercise to enhance antidepressant treatment are discussed. Longer-term use of exercise is also likely to confer additional health benefits for this population.
由于标准抗抑郁药单一疗法的完全缓解率相当低，重度抑郁症患者中增效策略的使用正在增加。临床和神经生物学数据表明，运动可能是作为抑郁症增效治疗的一个良好选择。这项初步研究考察了运动对重度抑郁症患者抗抑郁药物的增效作用。17名抑郁症状未完全缓解的患者开始了一项为期12周的运动计划，同时继续服用他们的抗抑郁药物（药物类型和剂量不变）。根据与当前推荐的公共卫生指南一致的运动剂量计算个人运动处方。运动包括监督指导的课程和居家锻炼课程。使用17项汉密尔顿抑郁评定量表（HRSD17）和抑郁症状自评量表（IDS-SR30）每周评估抑郁症状。意向性分析显示，HRSD17（降低5.8分，p<0.008）和IDS-SR30（降低13.9分，p<0.002）均有显著下降。对于完成研究的患者（n = 8），HRSD17评分下降了10.4分，IDS-SR30评分下降了18.8分。这项研究为运动作为抗抑郁药物的有效增效治疗提供了初步证据。这是一种低成本的增效策略，具有诸多健康益处，并且可能进一步减轻对抗抑郁治疗部分有效的患者的抑郁症状。文中还讨论了从业者如何利用运动来加强抗抑郁治疗的实用技巧。长期运动也可能为这一人群带来更多健康益处。
