Ball Susan G, Atkinson Sarah, Sparks JonDavid, Bangs Mark, Goldberger Celine, Dubé Sanjay
From the *Lilly Research Laboratories, Eli Lilly and Company; †Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN; ‡Finger Lakes Clinical Research, Rochester, NY; and §Department of Psychiatry, Stanford School of Medicine, Stanford, CA.
J Clin Psychopharmacol. 2015 Jun;35(3):266-72. doi: 10.1097/JCP.0000000000000302.
Long-term safety, tolerability, and efficacy of adjunctive edivoxetine hydrochloride (hereafter edivoxetine), a highly selective and potent norepinephrine reuptake inhibitor, was assessed in patients with major depressive disorder (MDD) experiencing partial response to selective serotonin reuptake inhibitor treatment. Data are from a multicenter, 54-week, open-label trial of adjunctive edivoxetine 12 to 18 mg once daily in patients with MDD who had experienced partial response by history to 6 or more weeks of current selective serotonin reuptake inhibitor therapy and who had a 17-item GRID Hamilton Rating Scale for Depression total score 16 or higher at study entry. Safety measures included discontinuation rate, treatment-emergent adverse events, serious adverse events, and vital signs. Efficacy measures included the Montgomery-Åsberg Depression Rating Scale. Of 608 patients, 328 (54%) completed the open-label adjunctive treatment. Study discontinuation due to adverse events occurred in 17.0%, and there were 13 serious adverse events (1 death). Treatment-emergent adverse events 5% or higher were nausea, hyperhidrosis, constipation, headache, dry mouth, dizziness, vomiting, insomnia, and upper respiratory tract infection. Mean increases were observed in systolic blood pressure (range, 0.0-2.3 mm Hg), diastolic blood pressure (range, 1.9-3.3 mm Hg), and pulse (range, 5.9-8.4 beats per minute). Mean improvements on the Montgomery-Åsberg Depression Rating Scale (-17.0) were observed from baseline to week 54. The safety profile from this study provides an overview of outcomes associated with edivoxetine and norepinephrine reuptake inhibition as an adjunctive treatment in patients with MDD who were treated up to 1 year.
在对选择性5-羟色胺再摄取抑制剂治疗仅出现部分反应的重度抑郁症(MDD)患者中,评估了高选择性强效去甲肾上腺素再摄取抑制剂盐酸依地西汀(以下简称依地西汀)作为辅助治疗的长期安全性、耐受性及疗效。数据来自一项多中心、为期54周的开放标签试验,该试验中,MDD患者每日一次服用12至18毫克依地西汀作为辅助治疗,这些患者既往对当前的选择性5-羟色胺再摄取抑制剂治疗6周或更长时间仅出现部分反应,且在研究入组时17项汉密尔顿抑郁量表总评分达16分或更高。安全性指标包括停药率、治疗中出现的不良事件、严重不良事件及生命体征。疗效指标包括蒙哥马利-Åsberg抑郁量表。608例患者中,328例(54%)完成了开放标签辅助治疗。因不良事件导致的研究停药率为17.0%,出现了13例严重不良事件(1例死亡)。发生率达5%或更高的治疗中出现的不良事件有恶心、多汗、便秘、头痛、口干、头晕、呕吐、失眠及上呼吸道感染。观察到收缩压(范围为0.0至2.3毫米汞柱)、舒张压(范围为1.9至3.3毫米汞柱)及脉搏(范围为每分钟5.9至8.4次搏动)均有平均升高。从基线至第54周,蒙哥马利-Åsberg抑郁量表平均改善了-17.0分。本研究的安全性概况概述了依地西汀及去甲肾上腺素再摄取抑制作为辅助治疗用于MDD患者长达1年的治疗结局。