Psychiatric Research Unit, Mental Health Centre North Zealand, Copenhagen University, Hillerød, Denmark.
Acta Psychiatr Scand. 2012 Apr;125(4):342-8. doi: 10.1111/j.1600-0447.2011.01791.x. Epub 2011 Nov 12.
To compare within the framework of a novel pharmacopsychometric triangle, augmentation treatment with bupropion vs. buspirone in the acute therapy of major depression in the STAR*D study. The triangle provides a composite view in three domains of antidepressive activity, side effects, and quality of life.
Within the pharmacopsychometric triangle, the short six-item subscales of the Hamilton Depression Scale (HAM-D(17)) and of the Inventory of Depressive Symptomatology (IDS-C(30)), referred to as HAM-D(6) and IDS-C(6), were focussed on pure antidepressive effect. Side-effects (tolerable vs. intolerable) and quality of life were measured using patient-administered questionnaires. A modified intention to treat sample was used.
Within the pharmacopsychometric triangle, bupropion-SR (sustained release) was superior to buspirone when augmented to the current citalopram treatment. Thus, in the domain of pure antidepressive effect, bupropion-SR was superior (P = 0.05) on the HAM-D(6), IDS-C(6), and IDS-C(30), but not on the HAM-D(17). In the domain of side effects, the total scores on the Patient Rated Inventory of Side Effects (PRISE) were reduced significantly more by bupropion-SR than by buspirone (P = 0.03). In the domain of quality of life, the total scores on the Quality of Life Enjoyment and Satisfaction Questionnaire (QLES-Q) showed a trend (P = 0.10) from baseline to endpoint of a superiority for bupropion-SR compared with buspirone.
In all domains of the pharmacopsychometric triangle, bupropion-SR was superior to buspirone as augmentation therapy in depressed outpatients not responding to citalopram.
在新型精神药理学三角的框架内，比较 STAR*D 研究中，安非他酮与丁螺环酮分别作为增效治疗药物，对重度抑郁症急性期的疗效。该三角提供了抗抑郁活性、副作用和生活质量三个领域的综合视图。
在精神药理学三角内，我们重点关注汉密尔顿抑郁量表（HAM-D(17)）和抑郁症状自评量表（IDS-C(30)）的简短六分量表（HAM-D(6)和 IDS-C(6)），它们代表了纯粹的抗抑郁作用。使用患者自评问卷来测量副作用（可耐受与不可耐受）和生活质量。采用修改后的意向治疗样本。
在精神药理学三角内，安非他酮持续释放（bupropion-SR）与丁螺环酮相比，在增强当前西酞普兰治疗方面更为有效。因此，在纯粹的抗抑郁作用领域，bupropion-SR 在 HAM-D(6)、IDS-C(6)和 IDS-C(30)上均优于丁螺环酮（P = 0.05），但在 HAM-D(17)上则不然。在副作用领域，患者自评的副作用量表（PRISE）的总分显著降低，bupropion-SR 比丁螺环酮更为显著（P = 0.03）。在生活质量领域，生活质量享受和满意度问卷（QLES-Q）的总分显示出 bupropion-SR 相对于丁螺环酮的优势趋势（P = 0.10）。
在精神药理学三角的所有领域，与丁螺环酮相比，安非他酮-SR 作为增效治疗药物，对未对西酞普兰产生反应的门诊重度抑郁症患者更为有效。
