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补充ω-3多不饱和脂肪酸可缓解初诊、未用药的重度抑郁症患者的焦虑症状而非抑郁症状:一项随机临床试验

Omega-3 Polyunsaturated Fatty Acids Supplementation Alleviate Anxiety Rather Than Depressive Symptoms Among First-Diagnosed, Drug-Naïve Major Depressive Disorder Patients: A Randomized Clinical Trial.

作者信息

Yang Rong, Wang Lu, Jin Kun, Cao Song, Wu Chujun, Guo Jimin, Chen Jindong, Tang Hui, Tang Mimi

机构信息

Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Nutr. 2022 Jul 12;9:876152. doi: 10.3389/fnut.2022.876152. eCollection 2022.

Abstract

BACKGROUND

Omega-3 polyunsaturated fatty acids (n-3 PUFAs) augmentation of antidepressants has shown great potential in the prevention and treatment of major depressive disorders (MDD).

OBJECTIVE

To investigate the effect of n-3 PUFAs plus venlafaxine in patients with first-diagnosed, drug-naïve depression.

METHOD

A total of 72 outpatients with first-diagnosed depression were recruited. The daily dose of 2.4 g/day n-3 PUFAs or placebo plus venlafaxine was used for over 12 weeks. The outcomes were assessed by the Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), Beck depression inventory (BDI), and Self-rating anxiety scale (SAS).

RESULTS

Both groups exhibited improvement on clinical characteristics at week 4 and week 12 compared with baseline. The rate of responders for anxiety in n-3 PUFAs group (44.44%) was significantly higher than that in placebo group (21.21%) at week 4 (χ = 4.182, = 0.041), while week 12 did not show a difference (χ = 0.900, = 0.343). The rate of responders for depression at both week 4 (χ = 0.261, = 0.609) and week 12 (χ = 1.443, = 0.230) showed no significant difference between two groups. Further analysis found that Childhood Trauma Questionnaire (CTQ) had positive correlation with HAMA ( = 0.301, = 0.012), SAS ( = 0.246, = 0.015), HAMD ( = 0.252, = 0.038) and BDI ( = 0.233, = 0.022) with Pearson correlation analysis. Social Support Rating Scale (SSRS) had negative correlation with SAS ( = -0.244, = 0.015) and BDI ( = -0.365, = 0.000).

CONCLUSION

This trial found that n-3 PUFAs supplementation in favor of venlafaxine alleviated the anxiety symptoms rather than depressive symptoms at the early stage of treatment (4 weeks) for first-diagnosed, drug-naïve depressed patients. However, the advantage disappeared in long-term treatment. Furthermore, childhood abuse and social support are closely related to the clinical and biological characteristics of depression. Both childhood trauma and lack of social support might be predictors of poor prognosis in depression.

CLINICAL TRIAL REGISTRATION

[clinicaltrials.gov], identifier [NCT03295708].

摘要

背景

ω-3多不饱和脂肪酸(n-3 PUFAs)辅助抗抑郁药在重度抑郁症(MDD)的预防和治疗中显示出巨大潜力。

目的

探讨n-3 PUFAs联合文拉法辛对初诊、未用过药物的抑郁症患者的疗效。

方法

共招募72例初诊抑郁症门诊患者。使用每日2.4 g/d的n-3 PUFAs或安慰剂联合文拉法辛治疗12周以上。通过汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、贝克抑郁量表(BDI)和自评焦虑量表(SAS)评估疗效。

结果

与基线相比,两组在第4周和第12周时临床特征均有改善。第4周时,n-3 PUFAs组的焦虑有效率(44.44%)显著高于安慰剂组(21.21%)(χ = 4.182,P = 0.041),而第12周时无差异(χ = 0.900,P = 0.343)。两组在第4周(χ = 0.261,P = 0.609)和第12周(χ = 1.443,P = 0.230)时的抑郁有效率均无显著差异。进一步分析发现,儿童创伤问卷(CTQ)与HAMA(r = 0.301,P = 0.012)、SAS(r = 0.246,P = 0.015)、HAMD(r = 0.252,P = 0.038)和BDI(r = 于0.233,P = 0.022)呈正相关(Pearson相关分析)。社会支持评定量表(SSRS)与SAS(r = -0.244,P = 0.015)和BDI(r = -0.365,P = 0.000)呈负相关。

结论

本试验发现,对于初诊、未用过药物的抑郁症患者,在治疗早期(4周),补充n-3 PUFAs联合文拉法辛有利于缓解焦虑症状而非抑郁症状。然而,长期治疗后该优势消失。此外,童年期虐待和社会支持与抑郁症的临床及生物学特征密切相关。童年创伤和社会支持缺乏均可能是抑郁症预后不良的预测因素。

临床试验注册

[clinicaltrials.gov],标识符 [NCT03295708]。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7e9/9315396/e5cfd5e8b6a6/fnut-09-876152-g001.jpg

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