Wang Yen-Chin, Lin Hai-Ti, Lu Mong-Liang, Huang Ming-Chyi, Chen Chun-Hsin, Wu Tzu-Hua, Wang Sabrina, Mao Wei-Chung, Kuo Po-Hsiu, Chen Hsi-Chung
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
Department of Psychiatry, Wan-Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Front Psychiatry. 2019 Mar 18;10:129. doi: 10.3389/fpsyt.2019.00129. eCollection 2019.
High sedative use in a major depressive episode may imply specific clinical features. This study aims to examine the correlation between sedative use and clinical severity indicators in the initial treatment phase of first-onset major depressive disorder. A study cohort in the first episode of major depressive disorder was used to conduct pharmacological dissection. All participants had at least a 2-year follow-up period with a complete treatment record. The defined daily dose of antidepressants and augmentation agents were calculated as the antidepressant load and augmentation load, respectively. Sedative use, which was calculated as the equivalent dosage of lorazepam, were defined as the sedative load. These psychotropic loads were measured monthly and the averaged psychotropic loads for each day were obtained. A total of 106 individuals (75.5% female) were included. The mean duration of disease course in participants was 5.5 ± 3.5 years. In the multiple regression analysis, after controlling for other classes of psychotropics and comorbid anxiety disorders, the sedative load independently correlated with higher number of antidepressants used, higher number of antidepressant used with an adequate dose and duration, more psychiatric emergency and outpatient visits within 2 years of disease onset. High loading of sedatives correlated with several indicators of clinical severity in major depressive disorder. The sedative load may be used as a specifier to identify subgroups in patients with major depressive disorder.
在重度抑郁发作中大量使用镇静剂可能意味着特定的临床特征。本研究旨在探讨首次发作的重度抑郁症初始治疗阶段镇静剂使用与临床严重程度指标之间的相关性。使用重度抑郁症首次发作的研究队列进行药理学剖析。所有参与者均有至少2年的随访期及完整的治疗记录。抗抑郁药和增效剂的限定日剂量分别计算为抗抑郁负荷和增效负荷。镇静剂使用量以劳拉西泮等效剂量计算，定义为镇静负荷。每月测量这些精神药物负荷，并得出每天的平均精神药物负荷。共纳入106人（75.5%为女性）。参与者的平均病程为5.5±3.5年。在多元回归分析中，在控制其他类精神药物和共病焦虑症后，镇静负荷与使用的抗抑郁药数量较多、使用足够剂量和疗程的抗抑郁药数量较多、疾病发作2年内更多的精神科急诊和门诊就诊独立相关。高剂量镇静剂与重度抑郁症的几个临床严重程度指标相关。镇静负荷可作为识别重度抑郁症患者亚组的一个特征。
