Bergman Joseph, Miodownik Chanoch, Bersudsky Yuly, Sokolik Shmuel, Lerner Paul P, Kreinin Anatoly, Polakiewicz Jacob, Lerner Vladimir
Mental Health Center Tirat Carmel, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Clin Neuropharmacol. 2013 May-Jun;36(3):73-7. doi: 10.1097/WNF.0b013e31828ef969.
Depression is a widespread mental disorder in which nearly half of the affected people have recurrent symptoms. Drug combinations may produce cumulative adverse effects, especially in elderly and physically ill patients. It was demonstrated that curcumin possesses antidepressive activity in various animal models of depression, and a combination of curcumin with some antidepressants potentiates the antidepressive effect of these agents. We sought to evaluate the efficacy of curcumin as an antidepressive agent in a combination with other antidepressants in patients with major depression.
Forty patients with a first episode of depression participated in a 5-week, double-blind, randomized, placebo-controlled study. The subjects were treated with either 500-mg/d curcumin or placebo together with antidepressants (escitalopram or venlafaxine) during August 2010 until June 2011. The outcome measures were Clinical Global Impression-Severity Scale, Hamilton Depression Rating Scale, and Montgomery-Asberg Depression Rating Scale.
Analysis of variance showed significant positive changes in both groups from baseline to the end of the study in all scales of measurement. These changes became significant from the first visit after 7 days of treatment. There was no difference between curcumin and placebo, which means negative results. However, the patients in the curcumin group demonstrated a trend to a more rapid relief of depressive symptoms in comparison to those in the placebo group. None of the patients complained of any adverse effect during the study.
Although there is no definitive proof that curcumin can induce an earlier beneficial effect of antidepressive agents, it seems like an extended study is needed to prove it, using higher therapeutic doses of curcumin.
抑郁症是一种广泛存在的精神障碍,近半数患者有复发症状。药物联合使用可能产生累积不良反应,尤其是在老年患者和身体疾病患者中。已证明姜黄素在各种抑郁症动物模型中具有抗抑郁活性,且姜黄素与某些抗抑郁药联合使用可增强这些药物的抗抑郁效果。我们试图评估姜黄素与其他抗抑郁药联合使用对重度抑郁症患者的抗抑郁疗效。
40例首次发作抑郁症患者参与了一项为期5周的双盲、随机、安慰剂对照研究。2010年8月至2011年6月期间,受试者接受500毫克/天的姜黄素或安慰剂与抗抑郁药(艾司西酞普兰或文拉法辛)联合治疗。疗效指标为临床总体印象-严重程度量表、汉密尔顿抑郁量表和蒙哥马利-阿斯伯格抑郁量表。
方差分析显示,从基线到研究结束,两组在所有测量量表上均有显著的正向变化。这些变化在治疗7天后的首次访视时变得显著。姜黄素组和安慰剂组之间没有差异,这意味着结果为阴性。然而,与安慰剂组相比,姜黄素组患者的抑郁症状缓解趋势更快。在研究期间,没有患者抱怨任何不良反应。
虽然没有确凿证据表明姜黄素能使抗抑郁药更早产生有益效果,但似乎需要进行一项扩展研究,使用更高治疗剂量的姜黄素来证明这一点。