Quante Arnim, Zeugmann Sara, Luborzewski Alexander, Schommer Nicole, Langosch Jens, Born Christoph, Anghelescu Ion, Wolf Juergen
Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.
Hum Psychopharmacol. 2010 Mar;25(2):126-32. doi: 10.1002/hup.1096.
The use of atypical antipsychotics (AAPs) for the treatment of unipolar and bipolar depression has been more and more frequently evaluated, and aripiprazole showed positive effects in the treatment of unipolar depression. However, no placebo-controlled studies of adjunctive aripiprazole for the treatment of bipolar depression have been performed yet.
In this prospective, double-blind, placebo-controlled, randomized trial, 23 inpatients with bipolar depression according to DSM-IV criteria were included. Before randomization, patients had to be on a constant mood stabilizer treatment with lithium or valproate for at least 1 week. After inclusion, all patients were openly treated with additional citalopram and with additional aripiprazole or placebo for 6 weeks. The primary outcome parameter was the reduction in depressive symptoms according to the Hamilton Depression Rating Scale (HDRS) within 6 weeks.
After 6 weeks of treatment, the HDRS score decreased in both groups. There was no significant difference between both the groups at any point of time with respect to the HDRS.
Derived from this small pilot study, adjunctive aripiprazole does not seem to be a promising strategy for the acute treatment of bipolar depression. However, this lack of additional benefit seems to stem from the already good effectiveness of the control group, namely the treatment with citalopram.
非典型抗精神病药物（AAPs）用于治疗单相和双相抑郁症的评估越来越频繁，阿立哌唑在单相抑郁症治疗中显示出积极效果。然而，尚未进行阿立哌唑辅助治疗双相抑郁症的安慰剂对照研究。
在这项前瞻性、双盲、安慰剂对照、随机试验中，纳入了23例符合DSM-IV标准的双相抑郁症住院患者。随机分组前，患者必须接受锂盐或丙戊酸盐持续心境稳定剂治疗至少1周。纳入后，所有患者均接受额外的西酞普兰以及额外的阿立哌唑或安慰剂公开治疗6周。主要结局参数是6周内根据汉密尔顿抑郁量表（HDRS）评估的抑郁症状减轻情况。
治疗6周后，两组的HDRS评分均下降。两组在任何时间点的HDRS评分均无显著差异。
从这项小型试点研究来看，阿立哌唑辅助治疗似乎并非双相抑郁症急性治疗的有效策略。然而，这种额外益处的缺乏似乎源于对照组（即西酞普兰治疗）已经具有良好的疗效。
