Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th Floor, Boston, MA, USA; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 6th Floor, Boston, MA, USA.
J Affect Disord. 2019 Nov 1;258:102-108. doi: 10.1016/j.jad.2019.06.065. Epub 2019 Jul 2.
While riluzole has been investigated for the treatment of depression, little is known about its longer-term efficacy and optimal treatment duration in treatment-resistant depression (TRD). The objective of this study is to characterize the longer-term outcome of adjunctive riluzole therapy for TRD in an open-label extension of an 8-week acute treatment trial.
The data from 66 patients with TRD who received adjunctive riluzole in a 12-week open-label extension phase were analyzed. Response rates (⩾50% reduction in the Mongomery-Asberg Depression Rating Scale [MADRS] score), relapse rates (a MADRS score of ⩾22 in patients who had previously achieved response), and adverse events were examined in patients who had achieved response at the end of the acute phase and those who had not.
Among acute phase responders, the maintained response rate was 66.7% (8/12) and the relapse rate was 8.3% (1/12). In acute phase non-responders, the response rate was 24.1% (13/54). The most commonly reported adverse event was fatigue (9.1%). Three cases were considered serious adverse events; vomiting (n = 1), shortness of breath (n = 1), and aborted suicide attempt (n = 1).
This longer-term study was open-label and uncontrolled. The sample size was relatively small.
Longer-term adjunctive riluzole appears relatively well tolerated and beneficial for maintaining previous response. Additionally, approximately one fourth of patients who did not respond to 8-week antidepressant treatment might respond if treated with riluzole for 12 weeks. Those findings warrant further investigation because adjunctive riluzole could represent an option for treatment of depression when standard antidepressants have failed.
虽然利鲁唑已被研究用于治疗抑郁症，但对于治疗抵抗性抑郁症（TRD）的长期疗效和最佳治疗持续时间知之甚少。本研究的目的是在 8 周急性期治疗试验的开放标签扩展中，描述辅助利鲁唑治疗 TRD 的长期结局。
对接受辅助利鲁唑治疗的 66 例 TRD 患者在 12 周开放标签扩展期的数据进行了分析。在急性期结束时达到缓解的患者和未达到缓解的患者中，评估了缓解率（蒙哥马利-艾斯伯格抑郁评定量表[MADRS]评分降低 ⩾50%）、复发率（以前达到缓解的患者 MADRS 评分 ⩾22）和不良反应。
在急性期缓解者中，维持缓解率为 66.7%（12/18），复发率为 8.3%（1/12）。在急性期未缓解者中，缓解率为 24.1%（13/54）。最常见的不良反应是疲劳（9.1%）。有 3 例被认为是严重不良事件；呕吐（n=1）、呼吸急促（n=1）和自杀未遂（n=1）。
这项长期研究是开放标签和非对照的。样本量相对较小。
长期辅助利鲁唑似乎耐受性良好且对维持先前的反应有益。此外，如果用利鲁唑治疗 12 周，大约四分之一对 8 周抗抑郁治疗无反应的患者可能会有反应。这些发现值得进一步研究，因为在标准抗抑郁药治疗失败时，辅助利鲁唑可能是治疗抑郁症的一种选择。
