Siwek Marcin, Chrobak Adrian Andrzej, Krupa Anna Julia, Gorostowicz Aleksandra, Gerlich Adrian, Juryk Andrzej, Dudek Dominika
Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Zakład Zaburzeń Afektywnych.
Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii.
Psychiatr Pol. 2025 Feb 28;59(1):7-24. doi: 10.12740/PP/OnlineFirst/174432.
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used drugs to treat major depressive disorder (MDD). However, about 50% of MDD patients do not achieve treatment response to SSRIs and there is little evidence on which drugs are effective as second-line treatment in those who do not respond to SSRIs.
In this work, the data of 79 patients with MDD were analyzed to evaluate the effectiveness of trazodone XR in the group of individuals treated de novo and those switched to trazodone XR after failed treatment attempt with SSRIs. The assessments were performed at baseline and weeks 2, 4, 8 and 12 using tools to evaluate the degree of: depression (Montgomery-Åsberg Depression Rating Scale, clinician and patient-rated Quick Inventory of Depressive Symptomatology - the primary endpoints of the study), therapeutic effectiveness (Clinical Global Impression Scale), anhedonia (Snaith-Hamilton Pleasure Scale), anxiety (Hamilton Anxiety Rating Scale), insomnia (Athens Insomnia Scale), psychosocial functioning (Sheehan Disability Scale) and sexual functioning (Female Sexual Function Inventory in women/International Index of Erectile Function in men).
The rates of treatment response and remission were largely similar in both studied groups.
The results showed that effectiveness of trazodone XR in the treatment of patients with MDD who did not respond to SSRIs administered as first-line treatment of a particular depressive episode was comparable to that noted in patients treated de novo. Furthermore, trazodone XR effectively improved depression, anxiety, insomnia, anhedonia and psychosocial functioning in both studied groups. Additionally, trazodone XR as secondline treatment improved sexual functions in male subjects previously treated with SSRIs.
选择性5-羟色胺再摄取抑制剂(SSRIs)是治疗重度抑郁症(MDD)最常用的药物。然而,约50%的MDD患者对SSRIs治疗无反应,且几乎没有证据表明哪些药物对SSRIs治疗无效的患者作为二线治疗有效。
在本研究中,分析了79例MDD患者的数据,以评估曲唑酮缓释片在初治患者组以及在使用SSRIs治疗失败后改用曲唑酮缓释片的患者组中的有效性。使用评估工具在基线、第2、4、8和12周进行评估,以评估以下程度:抑郁(蒙哥马利-Åsberg抑郁评定量表、临床医生和患者评定的抑郁症状快速量表——研究的主要终点)、治疗效果(临床总体印象量表)、快感缺失(斯奈斯-汉密尔顿愉悦量表)、焦虑(汉密尔顿焦虑评定量表)、失眠(雅典失眠量表)、社会心理功能(希恩功能障碍量表)和性功能(女性用女性性功能量表/男性用国际勃起功能指数)。
两个研究组的治疗反应率和缓解率基本相似。
结果表明,曲唑酮缓释片对作为特定抑郁发作一线治疗使用SSRIs无效的MDD患者的治疗效果与初治患者相当。此外,曲唑酮缓释片在两个研究组中均有效改善了抑郁、焦虑、失眠、快感缺失和社会心理功能。此外,曲唑酮缓释片作为二线治疗改善了先前接受SSRIs治疗的男性患者的性功能。