Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, 20 N Pine St, Baltimore, MD 21201, USA.
Mol Neurodegener. 2010 Mar 12;5:10. doi: 10.1186/1750-1326-5-10.
There is a high prevalence rate (30-50%) of Alzheimer's disease (AD) and depression comorbidity. Depression can be a risk factor for the development of AD or it can be developed secondary to the neurodegenerative process. There are numerous documented diagnosis and treatment challenges for the patients who suffer comorbidity between these two diseases. Meta analysis studies have provided evidence for the safety and efficacy of antidepressants in treatment of depression in AD patients. Preclinical and clinical studies show the positive role of chronic administration of selective serotonin reuptake inhibitor (SSRI) antidepressants in hindering the progression of the AD and improving patient performance. A number of clinical studies suggest a beneficial role of combinatorial therapies that pair antidepressants with FDA approved AD drugs. Preclinical studies also demonstrate a favorable effect of natural antidepressants for AD patients. Based on the preclinical studies there are a number of plausible antidepressants effects that may modulate the progression of AD. These effects include an increase in neurogenesis, improvement in learning and memory, elevation in the levels of neurotrophic factors and pCREB and a reduction of amyloid peptide burden. Based on this preclinical and clinical evidence, antidepressants represent a rational complimentary strategy for the treatment of AD patients with depression comorbidity.
阿尔茨海默病(AD)和抑郁症共病的患病率很高(30-50%)。抑郁症可能是 AD 发展的一个危险因素,也可能是神经退行性过程的继发表现。对于同时患有这两种疾病的患者,存在大量有记录的诊断和治疗挑战。荟萃分析研究为抗抑郁药治疗 AD 患者的抑郁症的安全性和有效性提供了证据。临床前和临床研究表明,慢性使用选择性 5-羟色胺再摄取抑制剂(SSRI)抗抑郁药在阻止 AD 进展和改善患者表现方面具有积极作用。许多临床研究表明,将抗抑郁药与 FDA 批准的 AD 药物联合使用的组合疗法具有有益作用。临床前研究还证明了天然抗抑郁药对 AD 患者的有益作用。基于临床前研究,有许多合理的抗抑郁药作用可能调节 AD 的进展。这些作用包括增加神经发生、改善学习和记忆、提高神经营养因子和 pCREB 的水平以及减少淀粉样肽负担。基于这些临床前和临床证据,抗抑郁药代表了一种合理的互补策略,可用于治疗患有抑郁症共病的 AD 患者。
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