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褪黑素作为情绪障碍的一种治疗方法:一项系统评价。

Melatonin as a treatment for mood disorders: a systematic review.

作者信息

De Crescenzo F, Lennox A, Gibson J C, Cordey J H, Stockton S, Cowen P J, Quested D J

机构信息

Institute of Psychiatry and Clinical Psychology, Catholic University of Sacred Heart, Rome, Italy.

Oxford Health NHS Foundation Trust, Oxford, UK.

出版信息

Acta Psychiatr Scand. 2017 Dec;136(6):549-558. doi: 10.1111/acps.12755. Epub 2017 Jun 14.

Abstract

OBJECTIVE

Melatonin has been widely studied in the treatment of sleep disorders and evidence is accumulating on a possible role for melatonin influencing mood. Our aim was to determine the efficacy and acceptability of melatonin for mood disorders.

METHOD

We conducted a comprehensive systematic review of randomized clinical trials on patients with mood disorders, comparing melatonin to placebo.

RESULTS

Eight clinical trials were included; one study in bipolar, three in unipolar depression and four in seasonal affective disorder. We have only a small study on patients with bipolar disorder, while we have more studies testing melatonin as an augmentation strategy for depressive episodes in major depressive disorder and seasonal affective disorder. The acceptability and tolerability were good. We analyzed data from three trials on depressive episodes and found that the evidence for an effect of melatonin in improving mood symptoms is not significant (SMD = 0.37; 95% CI [-0.05, 0.37]; P = 0.09). The small sample size and the differences in methodology of the trials suggest that our results are based on data deriving from investigations occurring early in this field of study.

CONCLUSION

There is no evidence for an effect of melatonin on mood disorders, but the results are not conclusive and justify further research.

摘要

目的

褪黑素在睡眠障碍治疗方面已得到广泛研究,且越来越多的证据表明褪黑素可能对情绪有影响。我们的目的是确定褪黑素治疗情绪障碍的疗效和可接受性。

方法

我们对情绪障碍患者的随机临床试验进行了全面的系统评价,将褪黑素与安慰剂进行比较。

结果

纳入了八项临床试验;一项关于双相情感障碍,三项关于单相抑郁症,四项关于季节性情感障碍。我们仅有一项针对双相情感障碍患者的小型研究,而有更多研究将褪黑素作为重度抑郁症和季节性情感障碍抑郁发作的增效策略进行测试。其可接受性和耐受性良好。我们分析了三项关于抑郁发作试验的数据,发现褪黑素改善情绪症状的证据并不显著(标准化均数差=0.37;95%可信区间[-0.05, 0.37];P=0.09)。样本量小以及试验方法的差异表明,我们的结果是基于该研究领域早期调查得出的数据。

结论

没有证据表明褪黑素对情绪障碍有影响,但结果并不确凿,有必要进一步研究。

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