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在使用依他普仑和阿立哌唑辅助治疗的重度抑郁发作期间的疼痛严重程度和疼痛干扰:CAN-BIND-1 报告。

Pain severity and pain interference during major depressive episodes treated with escitalopram and aripiprazole adjunctive therapy: a CAN-BIND-1 report.

机构信息

Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.

School of Psychology and Clinical Language Sciences, University of Reading, Reading, Berkshire, United Kingdom.

出版信息

Psychiatry Res. 2022 Jun;312:114557. doi: 10.1016/j.psychres.2022.114557. Epub 2022 Apr 16.

Abstract

Escitalopram may have pain-alleviating effects for patients with comorbid pain and depression. This study aimed to quantify improvements in pain for patients on escitalopram and adjunctive aripiprazole. A secondary analysis of the CAN-BIND-1 trial was conducted which only included participants with a current depressive episode and pain. Participants received escitalopram (10-20mg) for eight weeks and treatment response was defined as a reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) of at least 50% from baseline. Non-responders at week 8 received adjunctive aripiprazole (2-10mg) for another eight weeks. The Brief Pain Inventory's pain severity (PSC) and pain interference (PIC) composite scores were measured at baseline, week 8, and week 16. Linear regression was used to determine how PSC and PIC differed between treatment responders and non-responders. Eighty-two participants with pain and depression received escitalopram. PSC and PIC decreased significantly regardless of treatment response at week 8, although responders had significantly lower PSC and PIC than non-responders. For the group receiving aripiprazole after week 8, neither PSC nor PIC improved further. Further research is needed to identify interventions that might treat both pain and depression symptoms.

摘要

依他普仑可能对伴有疼痛和抑郁的患者有缓解疼痛的作用。本研究旨在量化依他普仑联合阿立哌唑对患者疼痛的改善。对 CAN-BIND-1 试验进行了二次分析,仅纳入当前有抑郁发作和疼痛的参与者。参与者接受依他普仑(10-20mg)治疗 8 周,治疗反应定义为与基线相比,蒙哥马利-Åsberg 抑郁评定量表(MADRS)至少降低 50%。第 8 周未应答者再接受阿立哌唑(2-10mg)联合治疗 8 周。基线、第 8 周和第 16 周测量简明疼痛量表的疼痛严重程度(PSC)和疼痛干扰(PIC)综合评分。线性回归用于确定 PSC 和 PIC 在治疗反应者和无反应者之间的差异。82 名有疼痛和抑郁的参与者接受了依他普仑治疗。无论治疗反应如何,PSC 和 PIC 在第 8 周均显著降低,尽管反应者的 PSC 和 PIC 明显低于无反应者。对于第 8 周后接受阿立哌唑治疗的组,PSC 和 PIC 均未进一步改善。需要进一步研究以确定可能同时治疗疼痛和抑郁症状的干预措施。

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