Ontiveros A, Fontaine R, Elie R
Research Center, Louis H. Lafontaine Hospital, Montreal, Quebec, Canada.
Acta Psychiatr Scand. 1991 Mar;83(3):188-92. doi: 10.1111/j.1600-0447.1991.tb05522.x.
We carried out an open clinical study with 60 consecutive patients suffering from major depression with melancholia who were resistant to anti-depressants. After at least 6 weeks of desipramine (DMI) or fluoxetine (FX) without improvement, lithium carbonate was added to the anti-depressant. Semistructured clinical interviews using the 7-point Clinical Global Impression Scale and 90-item Symptom Checklist were done at baseline and weeks 1, 6 and 14. Following the addition of lithium, more patients on FX improved within the first week than those on DMI. However, with FX, 6 relapses occurred during the 2 months of follow-up and none with DMI. The unified serotonergic and noradrenergic hypothesis for the antidepressant action could be relevant in drug-refractory depression and should be studied further.
我们对60例连续的患有伴有忧郁症的重度抑郁症且对抗抑郁药耐药的患者进行了一项开放性临床研究。在使用去甲丙咪嗪（DMI）或氟西汀（FX）至少6周病情无改善后，将碳酸锂添加到抗抑郁药中。在基线以及第1、6和14周使用7点临床总体印象量表和90项症状清单进行半结构化临床访谈。添加锂后，第一周内FX组改善的患者比DMI组更多。然而，使用FX时，随访的2个月内有6例复发，而DMI组无复发。抗抑郁作用的统一5-羟色胺能和去甲肾上腺素能假说可能与难治性抑郁症相关，应进一步研究。
