Padala Prasad R, Padala Kalpana P, Majagi Anusha S, Garner Kimberly K, Dennis Richard A, Sullivan Dennis H
Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System.
Department of Psychiatry, University of Arkansas for Medical Sciences (UAMS.
Medicine (Baltimore). 2020 Aug 14;99(33):e21497. doi: 10.1097/MD.0000000000021497.
Selective serotonin reuptake inhibitors (SSRIs), commonly used to treat depression, are associated with loss of motivation, anergy, and lack of curiosity often referred collectively as apathy. However, this association has not been systematically assessed using a specific rating scale for measuring apathy syndrome. Our objective was to study the association between SSRI use and apathy syndrome.We conducted a retrospective chart review of 125 patients enrolled in an outpatient psychiatry clinic. The prevalence of apathy syndrome and its clinical significance (based on standardized assessment) were compared between patients treated and not treated with SSRIs. Apathy was assessed using the Apathy Evaluation Scale-clinician version with a score ranging 18-72 with higher score for worse apathy. A score of greater than 30 is considered clinically significant apathy.Among 119 patients, the mean apathy scores were significantly higher in those treated with SSRIs compared to those not treated with SSRIs (42.5 ± 9.2 vs 31.3 ± 6, P < .0001). The SSRI group also had a significantly higher percentage of patients with clinically significant apathy (92% vs 61%, P < .0001). Use of all SSRIs was associated with the presence of apathy. Apathy was seen in all mental health diagnostic categories with highest Apathy evaluation scale-clinician version scores in those with dementia.SSRI use may be associated with higher rates of apathy syndrome. Clinicians should specifically inquire about iatrogenic apathy syndrome when evaluating patients on an SSRI if there is suspicion of loss of motivation. Limitations of this study included retrospective nature of this study, and that majority of the sample was males. Prospective studies are needed to elucidate information regarding the prevalence, etiology, and treatment response for SSRI-associated apathy syndrome.
选择性5-羟色胺再摄取抑制剂(SSRIs)常用于治疗抑郁症,与动机丧失、无活力和缺乏好奇心有关,这些通常统称为冷漠。然而,尚未使用测量冷漠综合征的特定评分量表对这种关联进行系统评估。我们的目的是研究使用SSRIs与冷漠综合征之间的关联。
我们对一家门诊精神病诊所登记的125例患者进行了回顾性病历审查。比较了接受和未接受SSRIs治疗的患者中冷漠综合征的患病率及其临床意义(基于标准化评估)。使用冷漠评估量表临床版评估冷漠,评分范围为18 - 至72分,分数越高冷漠越严重。大于30分的评分被认为具有临床意义的冷漠。
在119例患者中,接受SSRIs治疗的患者的平均冷漠评分显著高于未接受SSRIs治疗的患者(42.5 ± 9.2对31.3 ± 6,P < 0.0001)。SSRIs组中具有临床意义的冷漠患者百分比也显著更高(92%对61%,P < 0.0001)。所有SSRIs 的使用均与冷漠的存在有关。在所有心理健康诊断类别中均可见冷漠,痴呆患者的冷漠评估量表临床版评分最高。
使用SSRIs可能与更高的冷漠综合征发生率有关。如果怀疑有动机丧失,临床医生在评估使用SSRIs的患者时应特别询问医源性冷漠综合征。本研究的局限性包括本研究的回顾性性质,以及样本大多数为男性。需要进行前瞻性研究以阐明有关SSRIs相关冷漠综合征的患病率、病因和治疗反应的信息。