Rosenberg P B, Ahmed I, Hurwitz S
Tufts-New England Medical Center Department of Psychiatry, Boston, Mass. 02111.
J Clin Psychiatry. 1991 Jun;52(6):263-7.
The purpose of the authors' study was to evaluate the efficacy of methylphenidate in the medically ill depressed patients and to examine the factors that appear to affect therapeutic response and side effects.
Hospital charts were reviewed for 29 patients who received trials of methylphenidate for treatment of depressive disorders while admitted to a medical/surgical unit.
Of the 29 patients, 16 (55%) had moderate or marked improvement, all within 2 days of commencing treatment with the maximal dose. Of the 25 nondelirious patients, 16 (64%) had moderate or marked improvement, and the presence of delirium was significantly associated with decreased response. Therapeutic response was significantly correlated with maximum methylphenidate dose. Side effects were noted in 8 (28%) patients; most side effects were mild (tachycardia or agitation), and all reversed after the medication was discontinued.
Methylphenidate provides a safe and effective alternative to tricyclic antidepressants in medically ill populations but appears to be less effective in the presence of delirium.
作者研究的目的是评估哌甲酯对患有躯体疾病的抑郁症患者的疗效，并探究似乎会影响治疗反应及副作用的因素。
回顾了29例在入住内科/外科病房期间接受哌甲酯治疗抑郁症试验的患者的医院病历。
29例患者中，16例（55%）有中度或显著改善，均在开始使用最大剂量治疗的2天内。25例无谵妄的患者中，16例（64%）有中度或显著改善，且谵妄的存在与反应降低显著相关。治疗反应与哌甲酯最大剂量显著相关。8例（28%）患者出现副作用；大多数副作用较轻（心动过速或激动），停药后均消失。
在患有躯体疾病的人群中，哌甲酯是三环类抗抑郁药的一种安全有效的替代药物，但在存在谵妄的情况下似乎效果较差。
