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急性地西泮对急性住院抑郁症患者情绪和中性记忆任务的影响差异。

Differential effects of acute diazepam on emotional and neutral memory tasks in acutely hospitalized depressed patients.

机构信息

Memory Center, Institute of Biomedical Research, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

出版信息

Neuropsychiatr Dis Treat. 2005 Sep;1(3):269-75.

Abstract

With the hypothesis that depression affects memory through a mechanism other than that of the benzodiazepines, the present study evaluated the acute effect of diazepam 10 mg upon explicit memory in patients with major depression. A double-blind, placebo (starch 50 mg) controlled experiment was carried out with 19 patients randomly divided into diazepam (n = 10) and placebo (n = 9) groups. They were evaluated by the Mini-Mental State Examination, and tests were conducted for immediate and delayed (short-term) memory with emotionally toned stimuli (negative, positive, neutral), recognition, and semantic memory in visual or auditory modality. The Visual Analog Mood scale (VAMS) was applied to measure anxiety and mood changes after the administration of drugs (30 minutes and 6 hours). Higher scores in the positively toned list among patients who received diazepam were observed, at the 30-minute compared with the 6-hour evaluation. The recall index of positive words in the diazepam group was positive and significantly different from the index of the placebo group. No anterograde amnesia following diazepam was observed. The neural model of a dysfunction of limbic prefrontal cortical structures that impairs the modulation of the amygdala in major depression may explain the present results. Consequently, the action of diazepam on the amygdala, which has been proposed to be the basis of its anxiolytic action, might be altered, modifying the modulation of memory in our patients.

摘要

基于抑郁通过不同于苯二氮䓬类药物的机制影响记忆这一假说,本研究评估了 10mg 地西泮对重性抑郁患者外显记忆的急性影响。采用双盲、安慰剂(淀粉 50mg)对照实验,将 19 例患者随机分为地西泮(n=10)和安慰剂(n=9)组。采用简易精神状态检查对其进行评估,并使用具有情绪色彩的刺激(负性、正性、中性)、识别和视听觉语义记忆进行即时和延迟(短期)记忆测试。应用视觉模拟情绪量表(VAMS)评估给药后 30 分钟和 6 小时的焦虑和情绪变化。与 6 小时评估相比,接受地西泮的患者在 30 分钟时正性列表中的得分更高。地西泮组的正性词汇回忆指数为正,与安慰剂组指数有显著差异。地西泮未引起顺行性遗忘。这一结果可能解释了重性抑郁患者边缘-前额皮质结构功能障碍的神经模型,该模型损害了杏仁核的调节功能。因此,地西泮对杏仁核的作用可能发生改变,从而改变了我们患者的记忆调节。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d77f/2416758/52af702f0133/ndt0103-269-01.jpg

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