Ansseau M, von Frenckell R, Gérard M A, Mertens C, De Wilde J, Botte L, Devoitille J M, Evrard J L, De Nayer A, Darimont P
Psychiatric Unit, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium.
Eur Neuropsychopharmacol. 1991 May;1(2):113-21. doi: 10.1016/0924-977x(91)90712-4.
A multicenter controlled study was designed to test the hypothesis that a loading dose of an antidepressant could shorten the latency of its clinical efficacy. Three parallel groups of about 40 endogenous depressive inpatients received either a loading dose of milnacipran (300 mg daily for 2 weeks and 150 mg daily during the 2 following weeks), the standard regimen of milnacipran in severe depression (200 mg daily for 4 weeks), or fluvoxamine (200 mg daily for 4 weeks). The duration of the study was 4 weeks, with assessments at baseline and after 4, 9, 14, 21, and 28 days of therapy by means of Montgomery and Asberg depression scale (MADS), the Hamilton depression scale, the Clinical Global Impressions (CGI), and a checklist of symptoms and side-effects. Results showed very similar evolution in the 3 treatment groups. In addition, the level of side-effects did not exhibit significant differences among the treatment groups, except for excitement-nervousness and akathisia which were more frequently reported with fluvoxamine. These results do not support the usefulness of a loading dose of an antidepressant such as milnacipran. They demonstrate however that milnacipran can be given at a 300 mg daily dose from the very first day of treatment with an excellent tolerance.
抗抑郁药的负荷剂量可缩短其临床疗效的潜伏期。三组平行的约40名内源性抑郁住院患者分别接受米那普明负荷剂量（前2周每日300 mg，接下来2周每日150 mg）、重度抑郁症米那普明标准方案（4周内每日200 mg）或氟伏沙明（4周内每日200 mg）治疗。研究为期4周，在基线以及治疗第4、9、14、21和28天通过蒙哥马利和阿斯伯格抑郁量表（MADS）、汉密尔顿抑郁量表、临床总体印象量表（CGI）以及症状和副作用清单进行评估。结果显示3个治疗组的病情进展非常相似。此外，除兴奋-紧张和静坐不能在氟伏沙明组报告更为频繁外，各治疗组间副作用水平无显著差异。这些结果不支持米那普明等抗抑郁药负荷剂量的有效性。然而，这些结果表明，从治疗第一天起米那普明就可以300 mg的日剂量给药，耐受性良好。
