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褪黑素与美金刚在减轻电休克治疗所致认知障碍中的疗效及安全性比较:一项随机临床试验

Comparison of the efficacy and safety of melatonin and memantine in the alleviation of cognitive impairments induced by electroconvulsive therapy: A randomized clinical trial.

作者信息

Sarraf Nazanin, Badri Taleb, Keshvari Negin, Ghassab-Sahebkar Ayfar, Qobadighadikolaei Roja, Abbasinazari Mohammad

机构信息

Department of Clinical Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran.

Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

J Clin Neurosci. 2020 Apr;74:146-150. doi: 10.1016/j.jocn.2020.02.011. Epub 2020 Feb 17.

DOI:10.1016/j.jocn.2020.02.011
PMID:32081599
Abstract

The purpose of this study was to assess and compare the efficacy and safety of melatonin and memantine in the alleviation of cognitive disorders in patients diagnosed with major depressive disorder (MDD) undergoing electroconvulsive therapy (ECT). Patients undergoing ECT for treatment of MDD were randomly allocated to the melatonin (3 mg/d) or memantine (5 mg/d) groups. The participants received either melatonin or memantine (tablet) through the ECT therapy, which was started at beginning the first day of ECT and continued to the sixth session. The Modified Mental State Examination (MMSE) was used to evaluate cognitive function before and after the intervention. Frothy eligible patients (22 females and 18 males) were studied. There was no significant difference between two groups in terms of demographic characteristics, hemodynamic parameters and baseline MMSE and item 3 MMSE. The Memantine group scored significantly higher at the end of the ECT sessions either by MMSE or item 3MMSE than the baseline (P = 0.04 and P = 0.03, respectively). In the melatonin group, both MMSE and item 3MMSE scores were decreased significantly than the baseline (p = 0.03 and p = 0.02, respectively). No withdrawal was observed due to the drugs' adverse effects. It seems that memantine (5 mg/d) is more effective than melatonin (3 mg/d), to alleviate cognitive disorders induced by ECT.

摘要

本研究旨在评估和比较褪黑素与美金刚在减轻接受电休克治疗(ECT)的重度抑郁症(MDD)患者认知障碍方面的疗效和安全性。接受ECT治疗MDD的患者被随机分配到褪黑素组(3毫克/天)或美金刚组(5毫克/天)。参与者在ECT治疗期间服用褪黑素或美金刚(片剂),从ECT治疗的第一天开始,持续到第六次治疗。采用改良精神状态检查表(MMSE)评估干预前后的认知功能。共研究了40例符合条件的患者(22名女性和18名男性)。两组在人口统计学特征、血流动力学参数、基线MMSE和第3项MMSE方面无显著差异。美金刚组在ECT治疗结束时,无论是MMSE评分还是第3项MMSE评分均显著高于基线(分别为P = 0.04和P = 0.03)。在褪黑素组中,MMSE和第3项MMSE评分均显著低于基线(分别为p = 0.03和p = 0.02)。未观察到因药物不良反应而退出研究的情况。似乎美金刚(5毫克/天)在减轻ECT诱导的认知障碍方面比褪黑素(3毫克/天)更有效。

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