Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 8078555, Japan.
Prog Neuropsychopharmacol Biol Psychiatry. 2010 Mar 17;34(2):308-12. doi: 10.1016/j.pnpbp.2009.12.003. Epub 2009 Dec 11.
Only two-thirds of depressive patients respond to antidepressant treatment. Recently, addition of an atypical antipsychotic drug to ongoing treatment with an antidepressant has been considered effective and well-tolerated. In the present study, we examined the effects of various atypical antipsychotic drugs as adjuvant to antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenaline reuptake inhibitors, tricyclic antidepressants and mood stabilizers, on plasma BDNF levels in refractory depressed patients. Forty-five patients who met the DSM-IV criteria for major depressive disorder (n=31) or bipolar disorder (10 with bipolar I, 4 with bipolar II) were enrolled in the study. Twenty-one were male and 24 were female, and their ages ranged from 28 to 71 (mean+/-SD=49+/-12) years. Plasma BDNF levels were measured using a sandwich ELISA. The plasma BDNF levels in responders (those showing a decline in HAM-D scores of 50% or more) were significantly increased 4weeks after the administration of each atypical antipsychotic drug, while the levels in non-responders were not changed. Furthermore, there was a significant correlation between the changes in HAM-D scores and the changes in plasma BDNF levels. These results suggest that adding an atypical antipsychotic drug to ongoing treatment with an antidepressant or mood stabilizer is useful and well-tolerated for refractory depressed patients, and the efficacy of atypical antipsychotics as an adjuvant might involve an increase of plasma BDNF levels.
仅有三分之二的抑郁患者对抗抑郁治疗有反应。最近，在持续的抗抑郁治疗中添加一种非典型抗精神病药物被认为是有效且耐受良好的。在本研究中，我们研究了各种非典型抗精神病药物作为抗抑郁药（包括选择性 5-羟色胺再摄取抑制剂（SSRIs）、5-羟色胺去甲肾上腺素再摄取抑制剂、三环抗抑郁药和心境稳定剂）的辅助治疗对难治性抑郁患者血浆 BDNF 水平的影响。45 名符合 DSM-IV 重性抑郁障碍（n=31）或双相障碍（10 名 I 型双相，4 名 II 型双相）标准的患者入组本研究。21 名男性，24 名女性，年龄 28-71 岁（均值+/-标准差=49+/-12）。使用夹心 ELISA 法测定血浆 BDNF 水平。应答者（HAM-D 评分下降 50%或更多的患者）的血浆 BDNF 水平在每种非典型抗精神病药物给药后 4 周显著升高，而非应答者的水平没有变化。此外，HAM-D 评分的变化与血浆 BDNF 水平的变化之间存在显著相关性。这些结果表明，在持续的抗抑郁治疗或心境稳定剂中添加非典型抗精神病药物对难治性抑郁患者是有用且耐受良好的，并且非典型抗精神病药物作为辅助治疗的疗效可能涉及血浆 BDNF 水平的增加。
