Mokhber N, Abdollahian E, Soltanifar A, Samadi R, Saghebi A, Haghighi M B, Azarpazhooh A
Psychiatry and Behavioral Sciences Research Center, lbn-e-Sina Hospital, Faculty of Medicine, Mashhad University of -Medical Sciences, Mashhad, Iran.
General Practice, Mashhad, Iran.
Pharmacopsychiatry. 2014 Jul;47(4-5):131-40. doi: 10.1055/s-0034-1377041. Epub 2014 Jun 23.
The effects of antidepressants on mood, cognition and the daily activities of Alzheimer patients are ambiguous. The effects of antidepressants SSRIs (serotonin specific reuptake inhibitors), TCAs (tricyclic antidepressants) and SNRIs (serotonin-norepinephrine reuptake inhibitors), in particular, are unknown.
This study aimed to compare the effects of sertraline, venlafaxine and desipramine on depression, cognition and the daily activities of Alzheimer patients.
This randomized double-blind trial was approved by the Research and Ethics Committees of Mashhad University of Medical Sciences. 59 moderate Alzheimer patients with major depressive disorder were randomly divided into 3 groups (sertraline, venlafaxine and desipramine), treated for 12 weeks (150 mg maximum dose) and assessed by the Hamilton Depression Test (HRSD), the Mini Mental State Examination (MMSE) and the Barthel index at the week 0 and the 2(nd), 4(th), 8(th), 12(th) weeks thereafter. Data were analyzed by SPSS software, using ANOVA and paired t-tests.
In the sertraline group, the results of all 3 tests, HRSD, MMSE and Barthel, in the 12(th) week showed significant improvements in comparison to the baseline (P<0.05 in all 3 tests). In the venlafaxine group, the results of MMSE and Barthel revealed significant improvements (P<0.05 in both tests). In the desipramine group, there was a significant improvement only in the Barthel test at the 12(th) week (P<0.05).
In this trial, sertraline treatment was associated with superior effectiveness in relation to depressive, cognitive, and behavioral symptoms.
抗抑郁药对阿尔茨海默病患者的情绪、认知及日常活动的影响尚不明确。尤其是选择性5-羟色胺再摄取抑制剂（SSRI）、三环类抗抑郁药（TCA）和5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）这几类抗抑郁药的效果未知。
本研究旨在比较舍曲林、文拉法辛和地昔帕明对阿尔茨海默病患者抑郁、认知及日常活动的影响。
本随机双盲试验经马什哈德医科大学研究与伦理委员会批准。59例患有重度抑郁症的中度阿尔茨海默病患者被随机分为3组（舍曲林组、文拉法辛组和地昔帕明组），接受为期12周的治疗（最大剂量150毫克），并在第0周以及之后的第2、4、8、12周通过汉密尔顿抑郁量表（HRSD）、简易精神状态检查表（MMSE）和巴氏指数进行评估。数据采用SPSS软件进行分析，运用方差分析和配对t检验。
在舍曲林组，第12周时HRSD、MMSE和巴氏指数这三项测试的结果与基线相比均有显著改善（三项测试P均<0.05）。在文拉法辛组，MMSE和巴氏指数的结果显示有显著改善（两项测试P均<0.05）。在地昔帕明组，仅在第12周的巴氏测试中有显著改善（P<0.05）。
在本试验中，舍曲林治疗在改善抑郁、认知和行为症状方面疗效更佳。
