Hwang Jeong Yeon, Choi Jae-Won, Kang Seung-Gul, Hwang Su Hwan, Kim Seog Ju, Lee Yu Jin
From the *Seoul National University College of Medicine; and †Department of Psychiatry, Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul; ‡Department of Psychiatry, Gil Medical Center, School of Medicine, Gachon University, Incheon; §Health Service Group, Samsung Electronics, Co, Ltd, Suwon; and ∥Department Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Clin Psychopharmacol. 2017 Jun;37(3):351-354. doi: 10.1097/JCP.0000000000000699.
PURPOSE/BACKGROUND: The aim of this study was to evaluate the effects of quetiapine XR and lithium on actigraphy-measured circadian parameters in patients with bipolar II depression.
METHODS/PROCEDURES: This was an 8-week, open-label, prospective, randomized comparative study. The assessments included the 17-item Hamilton Depression Rating Scale score and actigraphic measures concerning the previous 7 days, collected at each visit (weeks 0 [baseline], 1, 2, 4, 6, and 8); the actigraphic data were analyzed with a cosinor analysis.
FINDINGS/RESULTS: Medication, time, and the interaction between medication and time were significantly associated with acrophase for the entire group (Ps = 0.003, 0.020, and 0.042, respectively). More specifically, acrophase was significantly delayed at weeks 1 and 6 (Ps = 0.004 and 0.039, respectively) in the quetiapine XR group. The F statistics significantly increased over time for the entire group (P < 0.001), and there was a significant increase in F statistics on weeks 4 and 6 in the quetiapine XR group (Ps = 0.016 and 0.020, respectively) and on weeks 4 and 8 in the lithium group (Ps = 0.001 and 0.016, respectively). In addition, scores on the 17-item Hamilton Depression Rating Scale were significantly associated with the F statistics during 8 weeks for the entire group (P = 0.008).
IMPLICATIONS/CONCLUSIONS: Both quetiapine XR and lithium affected several circadian parameters, including peak activity time and robustness of circadian rhythm, but exerted different effects on acrophase in patients with bipolar II depression. In particular, clinical depressive symptoms were associated with robustness of circadian rhythm during the course of the 8-week treatment.
目的/背景：本研究旨在评估喹硫平缓释片和锂盐对双相II型抑郁症患者通过活动记录仪测量的昼夜节律参数的影响。
方法/步骤：这是一项为期8周的开放标签、前瞻性、随机对照研究。评估内容包括17项汉密尔顿抑郁量表评分以及每次访视（第0周[基线]、第1、2、4、6和8周）收集的关于前7天的活动记录仪测量数据；活动记录仪数据采用余弦分析法进行分析。
药物、时间以及药物与时间之间的相互作用在整个研究组中均与峰值相位显著相关（P值分别为0.003、0.020和0.042）。更具体地说，喹硫平缓释片组在第1周和第6周时峰值相位显著延迟（P值分别为0.004和0.039）。整个研究组的F统计量随时间显著增加（P<0.001），喹硫平缓释片组在第4周和第6周F统计量显著增加（P值分别为0.016和0.020），锂盐组在第4周和第8周F统计量显著增加（P值分别为0.001和0.016）。此外，整个研究组在8周内17项汉密尔顿抑郁量表评分与F统计量显著相关（P = 0.008）。
意义/结论：喹硫平缓释片和锂盐均影响多个昼夜节律参数，包括活动高峰时间和昼夜节律的稳健性，但对双相II型抑郁症患者的峰值相位产生不同影响。特别是，在8周治疗过程中，临床抑郁症状与昼夜节律的稳健性相关。
