University of Liège, Department of Psychiatry, CHU Sart Tilman B35, 4000 Liège, Belgium.
Psychiatr Danub. 2010 Nov;22 Suppl 1:S106-7.
Several acute depression trials suggest that only 35% of the patients achieve remission state with antidepressant monotherapy. An increasing body of evidence is emerging suggesting that multi-action antidepressants might be more effective in treatment-resistant depressed patients than single-action agents. In this context, the purpose of the study was to assess the effectiveness of duloxetine in treatment-resistant major depressed outpatients. We performed a retrospective study assessing the efficacy of duloxetine in major depressed outpatients who did not achieve full symptom remission (CGI-S (severity) >=3) after treatment of adequate dose and duration (more than 8 weeks) with at least either one SSRI or the SNRI venlafaxine. We excluded patients with a severe medical illness and a personality disorder. CGI-S was used as a measure of symptom severity and administered before the prescription of duloxetine and 6 weeks later. The sample included 29 patients (9 M, 20 F). We observed a very significant decrease in CGI-S scores (4.86 ± 0.51 to 2.17 ± 1.44, p<0.0001) after treatment with duloxetine (dose between 60 and 120 mg). Remission was achieved in 48% of the patients. The tolerance was excellent. This study suggests the potential interest of duloxetine in some treatment-resistant depressed patients.
几项急性抑郁症试验表明，只有 35%的患者通过抗抑郁单药治疗达到缓解状态。越来越多的证据表明，多作用抗抑郁药在治疗抵抗性抑郁症患者中可能比单作用药物更有效。在这种情况下，研究的目的是评估度洛西汀对治疗抵抗性重度抑郁症门诊患者的疗效。我们进行了一项回顾性研究，评估了度洛西汀在充分剂量和疗程（> 8 周）治疗后未达到完全症状缓解（CGI-S（严重程度）>=3）的重度抑郁症门诊患者中的疗效，这些患者至少接受了一种 SSRI 或 SNRI 文拉法辛治疗。我们排除了患有严重疾病和人格障碍的患者。CGI-S 用于衡量症状严重程度，并在开具度洛西汀之前和 6 周后进行评估。样本包括 29 名患者（9 名男性，20 名女性）。我们观察到，在使用度洛西汀治疗后（剂量为 60-120mg），CGI-S 评分显著下降（4.86±0.51 至 2.17±1.44，p<0.0001）。48%的患者达到缓解。耐受性极好。这项研究表明，度洛西汀可能对一些治疗抵抗性抑郁症患者有潜在的益处。
