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辅助单剂量肠外补充维生素D对合并维生素D缺乏的重度抑郁症的影响:一项双盲随机安慰剂对照试验。

Effect of adjunctive single dose parenteral Vitamin D supplementation in major depressive disorder with concurrent vitamin D deficiency: A double-blind randomized placebo-controlled trial.

作者信息

Vellekkatt Favaz, Menon Vikas, Rajappa Medha, Sahoo Jayaprakash

机构信息

Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India.

Department of Biochemistry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, 605006, India.

出版信息

J Psychiatr Res. 2020 Oct;129:250-256. doi: 10.1016/j.jpsychires.2020.07.037. Epub 2020 Aug 4.

Abstract

Adjunctive vitamin D replacement is a theoretically promising strategy to improve outcomes in major depression. Our objective was to assess the efficacy of a single parenteral dose of vitamin D supplementation at baseline as an adjunct to treatment as usual on change in depression symptom ratings (primary outcome), quality of life and clinical severity of illness (secondary outcomes) at the end of 12 weeks when compared to treatment as usual in patients with major depression and concurrent Vitamin D deficiency. Eligible participants were randomized to receive either treatment as usual (TAU; n = 23) or TAU plus single parenteral dose of 3,00,000 IU of vitamin D (n = 23) at baseline. Rater-blinded assessments of depression (primary outcome), quality of life (QoL) and clinical severity of illness were obtained at baseline, and end of follow-up (12 weeks). Intent-to-treat analyses were performed on the entire randomized sample. The intervention significantly improved depression symptom ratings, quality of life and clinical severity of illness at the end of the treatment phase. These findings indicate that a single parenteral dose (3,00,000 IU) of adjunctive vitamin D replacement at baseline is an effective and well tolerated intervention in major depressive disorder with concurrent Vitamin D deficiency. Additionally, it points to a possible role for vitamin D in the pathophysiology of depression and supports personalized approaches for treatment of major depressive disorder.

摘要

辅助补充维生素D是一种理论上很有前景的改善重度抑郁症治疗效果的策略。我们的目的是评估在基线时单次肠胃外补充维生素D作为常规治疗辅助手段,与重度抑郁症并发维生素D缺乏患者的常规治疗相比,在12周结束时对抑郁症状评分变化(主要结局)、生活质量和疾病临床严重程度(次要结局)的疗效。符合条件的参与者被随机分为两组,一组接受常规治疗(TAU;n = 23),另一组在基线时接受常规治疗加单次肠胃外注射300,000 IU维生素D(n = 23)。在基线和随访结束时(12周),对抑郁(主要结局)、生活质量(QoL)和疾病临床严重程度进行了评估者盲法评估。对整个随机样本进行了意向性分析。在治疗阶段结束时,干预措施显著改善了抑郁症状评分、生活质量和疾病临床严重程度。这些发现表明,在基线时单次肠胃外注射(300,000 IU)辅助补充维生素D对并发维生素D缺乏的重度抑郁症是一种有效且耐受性良好的干预措施。此外,这表明维生素D在抑郁症病理生理学中可能发挥作用,并支持重度抑郁症的个性化治疗方法。

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