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舍曲林、多虑平与文拉法辛对抑郁症患者非脑源性神经营养因子的影响:一项队列研究。

Effect of Sertraline, Dosulepin, and Venlafaxine on Non-BDNF Neurotrophins in Patients With Depression: A Cohort Study.

机构信息

From the Department of Pharmacology and Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.

出版信息

J Clin Psychopharmacol. 2019 May/Jun;39(3):220-225. doi: 10.1097/JCP.0000000000001022.

Abstract

BACKGROUND

The neurotrophic hypothesis of depression has been mostly studied with a focus on brain-derived neurotrophic factor (BDNF) leading to lack of data on non-BDNF neurotrophins (NTs). The aim of this study was to evaluate the effect of antidepressant drugs on changes in serum nerve growth factor (NGF), neurotrophin 3 (NT-3), and neurotrophin 4 (NT-4).

METHODS

A prospective cohort study was conducted on 105 patients with depression who were subgrouped to the group 1 (mild and moderate depression without somatic syndrome treated with sertraline), group 2 (mild and moderate depression with somatic syndrome treated with dosulepin), and group 3 (severe depression without psychotic symptoms treated with venlafaxine). At baseline, the severity of depression (Montgomery-Asberg Depression Rating Scale [MADRS]), serum NGF, NT-3, and NT-4 were estimated. Thirty-five healthy volunteers were recruited as controls for a baseline comparison of NTs. All patients were followed up after 6 weeks to evaluate the changes in NT levels and correlate it with the change in MADRS scores.

RESULTS

At baseline, NT levels were significantly lower in patients with depression in comparison with healthy control. In group 1, serum NGF, NT-3, and NT-4 level were found to increase significantly after treatment, whereas changes in groups 2 and 3 were statistically not significant. Montgomery-Asberg Depression Rating Scale score and serum NGF at baseline had an inverse relation (r = -0.648), whereas the change in MADRS score in sertraline group had a positive correlation (r = 0.86) with the change of serum NGF.

CONCLUSIONS

Monotherapy with sertraline increased the level of non-BDNF NTs; however, treatment with dosulepin and venlafaxine did not produce any significant changes in patients with depression.

摘要

背景

抑郁症的神经营养假说主要集中在脑源性神经营养因子(BDNF)上,导致非 BDNF 神经营养因子(NTs)的数据缺乏。本研究旨在评估抗抑郁药物对血清神经生长因子(NGF)、神经营养因子 3(NT-3)和神经营养因子 4(NT-4)变化的影响。

方法

对 105 例抑郁症患者进行前瞻性队列研究,将其分为 3 组:1 组(无躯体综合征的轻中度抑郁症,用舍曲林治疗);2 组(有躯体综合征的轻中度抑郁症,用多虑平治疗);3 组(无精神病症状的重度抑郁症,用文拉法辛治疗)。在基线时,评估抑郁严重程度(蒙哥马利-阿斯伯格抑郁评定量表[MADRS])、血清 NGF、NT-3 和 NT-4。招募 35 名健康志愿者作为对照组进行基线 NT 比较。所有患者在 6 周后进行随访,以评估 NT 水平的变化,并与 MADRS 评分的变化相关联。

结果

基线时,与健康对照组相比,抑郁症患者的 NT 水平显著降低。在 1 组中,血清 NGF、NT-3 和 NT-4 水平在治疗后明显升高,而 2 组和 3 组的变化无统计学意义。基线时 MADRS 评分与血清 NGF 呈负相关(r = -0.648),而舍曲林组 MADRS 评分的变化与血清 NGF 的变化呈正相关(r = 0.86)。

结论

舍曲林单药治疗可提高非 BDNF NT 水平;然而,多虑平和文拉法辛治疗对抑郁症患者没有产生任何显著变化。

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