From the Department of Psychiatry, Tepecik Training and Research Hospital, İzmir.
Psychiatry Clinic, Manisa Mental Health and Diseases Hospital, Manisa.
J Clin Psychopharmacol. 2020 Nov/Dec;40(6):594-598. doi: 10.1097/JCP.0000000000001300.
PURPOSE/BACKGROUND: Emotional adverse effects due to antidepressant use may cause difficulties for the clinician in the treatment of depression. In this prospective study, the emotional adverse effects of antidepressants were evaluated in various aspects.
METHODS/PROCEDURES: Ninety eight patients diagnosed with major depressive disorder were included in the study. At 2nd, 4th, 8th, 12th, and 16th weeks, patients were assessed with Montgomery-Asberg Depression Rating Scale (MADRS), and the antidepressant dose was increased in patients with less than a 50% reduction at each visit compared with the initial MADRS score. The Oxford Questionnaire on the Emotional Side-effects of Antidepressants (OQESA) was used at the 8th-week and 16th-week visits.
FINDINGS/RESULTS: A significant difference is found in the OQESA score at the 8th-week visit compared with the 16th-week assessment (P < 0.001, t = 5.73). There were significant correlations between MADRS scores and OQESA scores both at the 8th (r = 0.346, P = 0.05) and the 16th (r = 0.490, P < 0.001) weeks. In regression analyses, at eighth-week assessment, MADRS score (B = 1.487, P = 0.002) and selective serotonin reuptake inhibitor use (B = 14.014, P = 0.023) had a significantly predicted OQESA score.
IMPLICATIONS/CONCLUSIONS: In this study, it is found that, as the rate of remitted patients is increased, OQESA scores get decreased, and furthermore, the OQESA score of the remitted group is statistically low when compared with that of the nonremitted group at the 8th- and 16th-week visits. Oxford Questionnaire on the Emotional Side-effects of Antidepressants and MADRS scores are significantly correlated in all assessments. These results suggest that the score obtained from OQESA may be related not only to the emotional adverse effects of antidepressants but also to the residual symptoms of depression.
目的/背景:抗抑郁药引起的情绪不良反应可能会给临床医生的抑郁症治疗带来困难。在这项前瞻性研究中,评估了抗抑郁药在各个方面的情绪不良反应。
方法/过程:本研究纳入了 98 例被诊断为重度抑郁症的患者。在第 2、4、8、12 和 16 周时,使用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)对患者进行评估,如果与初始 MADRS 评分相比,每位患者的评分减少不足 50%,则会增加抗抑郁药的剂量。在第 8 周和第 16 周就诊时使用牛津抗抑郁药情绪副作用问卷(OQESA)。
第 8 周就诊时的 OQESA 评分与第 16 周评估时相比有显著差异(P < 0.001,t = 5.73)。在第 8 周和第 16 周时,MADRS 评分与 OQESA 评分之间均存在显著相关性(r = 0.346,P = 0.05;r = 0.490,P < 0.001)。在回归分析中,在第 8 周评估时,MADRS 评分(B = 1.487,P = 0.002)和选择性 5-羟色胺再摄取抑制剂的使用(B = 14.014,P = 0.023)对 OQESA 评分有显著的预测作用。
在这项研究中发现,随着缓解患者的比例增加,OQESA 评分降低,而且,在第 8 周和第 16 周就诊时,缓解组的 OQESA 评分明显低于未缓解组。在所有评估中,牛津抗抑郁药情绪副作用问卷和 MADRS 评分均显著相关。这些结果表明,OQESA 获得的评分不仅与抗抑郁药的情绪不良反应有关,而且与抑郁症的残留症状有关。