Ielmini Marta, Caselli Ivano, Ceccon Francesca, Diurni Marcello, Poloni Nicola, Callegari Camilla
Ielmini, Caselli, Ceccon, Diurni, Poloni, Callegari, Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese (VA), Italy.
Psychopharmacol Bull. 2021 Nov 3;51(4):31-39.
Major depressive disorder (MDD) is a primary cause of disability in adults, affecting daily functioning and decreasing quality of life. The focus on the role of nutraceuticals as adjunctive treatments to improve antidepressant response is paying growing interest. The study aims to compare the antidepressants response in the utilization of selective serotonin reuptake inhibitors (SSRIs) versus a combination of SSRIs and nutraceutical supplements based on S-Adenosyl methionine (SAMe), N-acetylcysteine (NAC) and folate in terms of efficacy and tolerability.
A case-control study was carried out between March 2018 and September 2019. Cases and controls were evaluated through the following scales: Hospital Anxiety Depression Scale (HADS); Clinical Global Impression (CGI); Patient Global Impression of Improvement (PGI-I); Antidepressant Adverse Events checklist (AES).
A significant difference between the two groups of patients emerged at T in the HADS-A (p = 0.004) score and in the CGI score (p = 0.01), due to a major improvement in patients with a nutraceutical co-prescription. At T a significant statistical difference emerged, showing a greater improvement at HADS-D in the case group (p = 0.006), confirmed by a higher remission rate in patients taking a nutraceutical co-prescription. No differences in terms of adverse events emerged.
This study shows promising data about the role of nutraceuticals as adjunctive treatment in major depressive disorder to improve SSRIs efficacy, with good tolerability. More data are needed to confirm these results, particularly about the role of nutraceuticals to decrease the latency of SSRIs response.
重度抑郁症（MDD）是成年人残疾的主要原因，影响日常功能并降低生活质量。营养保健品作为辅助治疗手段以改善抗抑郁反应的作用正受到越来越多的关注。本研究旨在比较选择性5-羟色胺再摄取抑制剂（SSRIs）与基于S-腺苷甲硫氨酸（SAMe）、N-乙酰半胱氨酸（NAC）和叶酸的SSRIs与营养保健品组合在疗效和耐受性方面的抗抑郁反应。
2018年3月至2019年9月进行了一项病例对照研究。通过以下量表对病例和对照进行评估：医院焦虑抑郁量表（HADS）；临床总体印象（CGI）；患者总体改善印象（PGI-I）；抗抑郁药物不良事件清单（AES）。
两组患者在T时的HADS-A评分（p = 0.004）和CGI评分（p = 0.01）出现显著差异，这是由于营养保健品联合处方患者有更大改善。在T时出现显著统计学差异，病例组在HADS-D方面改善更大（p = 0.006），服用营养保健品联合处方患者的缓解率更高证实了这一点。在不良事件方面未出现差异。
本研究显示了关于营养保健品作为重度抑郁症辅助治疗以提高SSRIs疗效且耐受性良好的有前景的数据。需要更多数据来证实这些结果，特别是关于营养保健品减少SSRIs反应潜伏期作用的数据。
