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美金刚治疗平民创伤后应激障碍的疗效:一项开放标签试验。

The efficacy of memantine in the treatment of civilian posttraumatic stress disorder: an open-label trial.

作者信息

Hori Hiroaki, Itoh Mariko, Matsui Mie, Kamo Toshiko, Saito Takuya, Nishimatsu Yoshiko, Kito Satoshi, Kida Satoshi, Kim Yoshiharu

机构信息

Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Department of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan.

出版信息

Eur J Psychotraumatol. 2021 Jan 15;12(1):1859821. doi: 10.1080/20008198.2020.1859821.

Abstract

: Currently, there is a paucity of pharmacological treatment options for posttraumatic stress disorder (PTSD), and the development of a novel pharmacotherapeutic approach has become a matter of great interest. : We conducted a 12-week open-label clinical trial to examine the efficacy and safety of memantine, an -methyl-D-aspartate receptor antagonist, in the treatment of civilian PTSD. : Thirteen adult patients with DSM-IV PTSD, all civilian women, were enrolled. They were monitored at an ambulatory care facility every week until 4 weeks and then every 4 weeks until 12 weeks. Memantine was added to each patient's current medication, with the initial dosage of 5 mg/day and then titrated. Concomitant medications were essentially kept unchanged during the trial. The primary outcome was PTSD diagnosis and severity assessed with the Posttraumatic Diagnostic Scale (PDS). : Of the 13 cases, one dropped out and two were discarded due to the protocol deviation, and the analysis was done for the remaining 10. Mean PDS total scores decreased from 32.3 ± 9.7 at baseline to 12.2 ± 7.9 at endpoint, which was statistically significant with a large effect (paired -test: = .002, = 1.35); intrusion, avoidance, hyperarousal symptoms were all significantly improved from baseline to endpoint. Six patients no longer fulfilled the diagnostic criteria of PTSD at endpoint. Some adverse, but not serious, effects possibly related to memantine were observed, including sleep problems, sleepiness, sedation, weight change and hypotension. : Memantine significantly reduced PTSD symptoms in civilian female PTSD patients and the drug was well tolerated. Future randomized controlled trials are necessary to verify the efficacy and safety of memantine in the treatment of PTSD.

摘要

目前,创伤后应激障碍(PTSD)的药物治疗选择匮乏,因此开发一种新的药物治疗方法已成为备受关注的问题。我们进行了一项为期12周的开放标签临床试验,以检验N-甲基-D-天冬氨酸受体拮抗剂美金刚治疗平民创伤后应激障碍的疗效和安全性。招募了13名符合《精神疾病诊断与统计手册》第四版(DSM-IV)标准的成年创伤后应激障碍患者,均为平民女性。在门诊护理机构每周对她们进行监测,持续4周,之后每4周监测一次,直至12周。美金刚添加到每位患者当前的药物治疗中,初始剂量为5毫克/天,然后进行滴定。试验期间,伴随用药基本保持不变。主要结局是使用创伤后诊断量表(PDS)评估创伤后应激障碍的诊断和严重程度。13例患者中,1例退出,2例因违反方案被剔除,对其余10例进行分析。PDS总分均值从基线时的32.3±9.7降至终点时的12.2±7.9,具有统计学意义且效果显著(配对t检验:t = 0.002,d = 1.35);闯入、回避、过度警觉症状从基线到终点均有显著改善。6例患者在终点时不再符合创伤后应激障碍的诊断标准。观察到一些可能与美金刚相关的不良但不严重的效应,包括睡眠问题、嗜睡、镇静、体重变化和低血压。美金刚显著减轻了平民女性创伤后应激障碍患者的症状,且该药物耐受性良好。未来有必要进行随机对照试验以验证美金刚治疗创伤后应激障碍的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5715/7874937/5bf8eaa94188/ZEPT_A_1859821_F0001_OC.jpg

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