Bonnet Udo, Specka Michael, Leweke F Markus, Nyhuis Peter, Banger Markus
Rheinische Kliniken Essen, Klinik für Psychiatrie und Psychotherapie und Klinik für abhängiges Verhalten und Suchtmedizin, Universität Duisburg-Essen, Virchowstr. 174, D-45147 Essen, Germany.
Prog Neuropsychopharmacol Biol Psychiatry. 2007 Mar 30;31(2):434-8. doi: 10.1016/j.pnpbp.2006.11.006. Epub 2006 Dec 18.
Delayed beneficial effects of gabapentin on mood were frequently reported in various patient populations. This is the first controlled study which addressed acute effects of gabapentin on mood.
Analysis of the German version of Profile of Mood States (POMS) throughout a randomised placebo-controlled, double-blinded study of gabapentin on acute alcohol withdrawal [Bonnet, U., Banger, M., Leweke, F.M., Specka, M., Müller, B.W., Hashemi, T., Nyhuis, P.W., Kutscher, S., Burtscheidt, W., Gastpar, M. 2003. Treatment of acute alcohol withdrawal with gabapentin -- results from a controlled two-center trial. J Clin Psychopharmacol 23, 514-519]. In addition, subjective severity of alcohol withdrawal was determined by the Essen Self-Assessment of Alcohol Withdrawal Scale (ESA) to control effects of concurrent withdrawal on POMS. Ratings were performed at intake (baseline), day 1 (study medication 400 mg q.i.d.), day 2 (study medication 400 mg q.i.d.) and day 7 (no study medication).
Analyses could be performed on 46 out of 59 randomised subjects. Within the first two days of the study, a significant stronger increase in the POMS-vigour subscore occurred in the gabapentin group. A subgroup analysis suggests that gabapentin's effect on vigour largely results from a stronger improvement of vigour in a small group of 11 patients with co-morbid mild depression (according to ICD-10: dysthymia or depressive adjustment disorder). There were no significant differences between the treatment groups regarding the other POMS-subscores (dejection, fatigue, anger) ruling out an overall fast effect on mood. Moreover, ESA-measures were not significantly altered indicating a missing effect of 400 mg gabapentin q.i.d. on acute alcohol withdrawal itself. After tapering off study medication, no more significant differences between gabapentin and placebo group were observed on vigour, strongly suggesting that the initial effect results from a pharmacological gabapentin action.
Gabapentin selectively accelerated the improvement of the vigour-subscore of patients with acute alcohol withdrawal within 48 h. This effect was independent from the subjective severity of withdrawal and especially marked in patients with co-morbid mild depression.
加巴喷丁对情绪的延迟有益作用在各类患者群体中经常被报道。这是第一项探讨加巴喷丁对情绪急性影响的对照研究。
在一项关于加巴喷丁治疗急性酒精戒断的随机、安慰剂对照、双盲研究[邦内特，U.，班格，M.，勒韦克，F.M.，斯佩卡，M.，米勒，B.W.，哈希米，T.，尼胡伊斯，P.W.，库舍尔，S.，布尔切特，W.，加斯帕尔，M. 2003年。加巴喷丁治疗急性酒精戒断——一项对照双中心试验的结果。《临床精神药理学杂志》23，514 - 519]中，对德语版的情绪状态剖面图（POMS）进行分析。此外，通过埃森酒精戒断自我评估量表（ESA）确定酒精戒断的主观严重程度，以控制同时戒断对POMS的影响。在入组时（基线）、第1天（研究药物400毫克，每日4次）、第2天（研究药物400毫克，每日4次）和第7天（无研究药物）进行评分。
59名随机受试者中有46名可进行分析。在研究的前两天内，加巴喷丁组POMS活力子量表的增加显著更强。亚组分析表明，加巴喷丁对活力的影响很大程度上源于一小群11名患有共病轻度抑郁症（根据ICD - 10：恶劣心境或抑郁性适应障碍）患者活力的更强改善。在其他POMS子量表（沮丧、疲劳、愤怒）方面，治疗组之间没有显著差异，排除了对情绪的整体快速影响。此外，ESA测量值没有显著改变，表明每日4次400毫克加巴喷丁对急性酒精戒断本身没有作用。在逐渐减少研究药物剂量后，加巴喷丁组和安慰剂组在活力方面没有再观察到显著差异，强烈表明最初的效果是由加巴喷丁的药理作用引起的。
加巴喷丁在48小时内选择性地加速了急性酒精戒断患者活力子量表的改善。这种作用与戒断的主观严重程度无关，在患有共病轻度抑郁症的患者中尤为明显。
