Psychiatry Department, Shalvata Mental Health Center, Tel Aviv University, Hamargoa 4, POB 94, Tel Aviv, Israel.
Eur Psychiatry. 2012 Oct;27(7):518-21. doi: 10.1016/j.eurpsy.2011.03.006. Epub 2011 Jun 12.
Major depressive disorder (MDD) is often accompanied by significant cognitive impairment, and there are limited interventions specific to this particular symptom. S-adenosylmethionine (SAMe), a naturally occurring molecule which serves as a major methyl-donor in human cellular metabolism, is required for the synthesis and maintenance of several neurotransmitters that have been implicated in the pathophysiology and treatment of cognitive dysfunction in MDD.
This study is a secondary analysis of a clinical trial involving the use of adjunctive SAMe for MDD.
Forty-six serotonin-reuptake inhibitor (SRI) non-responders with MDD enrolled in a 6-week, double-blind, randomized trial of adjunctive oral SAMe were administered the self-rated cognitive and physical symptoms questionnaire (CPFQ), a validated measure of cognitive as well as physical symptoms of MDD, before and after treatment.
There was a greater improvement in the ability to recall information (P=0.04) and a trend towards statistical significance for greater improvement in word-finding (P=0.09) for patients who received adjunctive SAMe than placebo. None of the remaining five items reached statistical significance.
These preliminary data suggest that SAMe can improve memory-related cognitive symptoms in depressed patients, and warrant replication.
重度抑郁症(MDD)常伴有明显的认知障碍,针对这一特定症状的干预措施有限。S-腺苷甲硫氨酸(SAMe)是一种天然存在的分子,作为人类细胞代谢中的主要甲基供体,是合成和维持几种神经递质所必需的,这些神经递质与 MDD 认知功能障碍的病理生理学和治疗有关。
本研究是一项涉及辅助使用 SAMe 治疗 MDD 的临床试验的二次分析。
46 名对选择性 5-羟色胺再摄取抑制剂(SRI)无反应的 MDD 患者参加了一项为期 6 周的双盲、随机试验,接受辅助口服 SAMe 治疗。在治疗前后,他们接受了自我评定认知和身体症状问卷(CPFQ)的评估,这是一种评估 MDD 认知和身体症状的有效工具。
与安慰剂组相比,接受辅助 SAMe 的患者在信息回忆能力(P=0.04)方面有更大的改善,在寻找单词方面也有更大的改善趋势(P=0.09),但其余五个项目均未达到统计学意义。
这些初步数据表明,SAMe 可以改善抑郁患者与记忆相关的认知症状,值得进一步研究。