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血清脑源性神经营养因子和白细胞介素-6 水平与拉莫三嗪增效治疗难治性抑郁症的治疗反应无关。

Both Serum Brain-Derived Neurotrophic Factor and Interleukin-6 Levels Are Not Associated with Therapeutic Response to Lamotrigine Augmentation Therapy in Treatment-Resistant Depressive Disorder.

机构信息

Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

Department of Hospital Pharmacy, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

出版信息

Neuropsychobiology. 2017;75(3):145-150. doi: 10.1159/000484665. Epub 2018 Jan 12.

Abstract

BACKGROUND/AIMS: Serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) were prospectively monitored in relation with therapeutic response to lamotrigine augmentation therapy in 46 (15 males and 31 females) inpatients with treatment-resistant depressive disorder during an 8-week treatment with lamotrigine using an open-study design.

METHODS

The subjects were 46 depressed patients who had already shown insufficient response to at least 3 psychotropics including antidepressants, mood stabilizers, and atypical antipsychotics. The diagnoses were major depressive disorder (n = 19), bipolar I disorder (n = 6), and bipolar II disorder (n = 22). The final doses of lamotrigine were 100 mg/day for 26 subjects who were not taking valproate and 75 mg/day for 20 subjects taking valproate, respectively. Depressive symptoms were evaluated by the Montgomery-Åsberg Depression Rating Scale (MADRS) before and after the 8-week treatment. Blood sampling was performed before the start of lamotrigine treatment and at week 8. Serum BDNF and IL-6 levels were measured using quantitative sandwich enzyme immunoassays.

RESULTS

No significant changes in serum BDNF or IL-6 levels during the 8-week lamotrigine treatment were observed in the total of subjects, responders or nonresponders. There was no significant correlation between the changes in serum BDNF or IL-6 levels and the percent improvement in MADRS scores in the overall subjects.

CONCLUSION

The present study suggests that the acute effect of lamotrigine augmentation therapy for a major depressive episode is not related to either BDNF or IL-6, at least in patients with treatment-resistant depressive disorder.

摘要

背景/目的:采用开放研究设计,前瞻性监测 46 例(男 15 例,女 31 例)治疗抵抗性抑郁症住院患者在接受拉莫三嗪加用治疗的 8 周期间,血清脑源性神经营养因子(BDNF)和白细胞介素-6(IL-6)水平与治疗反应的关系。

方法

该研究对象为 46 例抑郁患者,他们在接受至少 3 种精神药物治疗(包括抗抑郁药、心境稳定剂和非典型抗精神病药)后反应不足。诊断为:重型抑郁症(n=19)、单相 I 型障碍(n=6)和双相 II 型障碍(n=22)。拉莫三嗪的最终剂量为:未服用丙戊酸的 26 例患者每日 100mg,服用丙戊酸的 20 例患者每日 75mg。在 8 周治疗前后,采用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)评估抑郁症状。在开始拉莫三嗪治疗前和第 8 周进行采血。采用定量夹心酶联免疫吸附试验测量血清 BDNF 和 IL-6 水平。

结果

在总人群、应答者或无应答者中,均未观察到 8 周拉莫三嗪治疗期间血清 BDNF 或 IL-6 水平的显著变化。在所有受试者中,血清 BDNF 或 IL-6 水平的变化与 MADRS 评分的改善百分比之间无显著相关性。

结论

本研究提示,拉莫三嗪加用治疗首发重性抑郁发作的急性效应与 BDNF 或 IL-6 无关,至少在治疗抵抗性抑郁症患者中是这样。

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