Mușat Mădălina Iuliana, Militaru Felicia, Gheorman Victor, Udriștoiu Ion, Mitran Smaranda Ioana, Cătălin Bogdan
U.M.F. Doctoral School Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Diagnostics (Basel). 2024 May 30;14(11):1140. doi: 10.3390/diagnostics14111140.
While depression can be associated with multiple comorbidities, the association between depression and liver injury significantly increases the mortality risk. The aim of this study was to evaluate if moderate alcohol intake affects the rate of clinical relapses in patients treated with antidepressants as monotherapy.
We assessed, over a period of 30 months, the clinical records of 254 patients with depressive disorder, of either gender, without additional pathologies, receiving monotherapy treatment with antidepressants. Thirty-three patients with alcohol abuse, alcoholism or significant cognitive impairment were excluded. The medical and psychiatric history, medication and liver enzyme values were collected and analyzed.
Out of the 221 patients who met the inclusion criteria, 78 experienced relapses of depression. The rate of relapse did not correlate with the levels of liver enzymes. Alcohol consumption, as objectified based on GGT levels and the AST/ALT ratio, suggested that men had higher alcohol intake compared to women. Patients treated with serotonin-norepinephrine reuptake inhibitors (SNRIs) with elevated AST levels were approximately 9 times more likely to relapse, while the ones with elevated GGT had a 5.34 times higher risk. While GGT levels remained a marker for relapse in men with elevated GGT, ALT and not AST proved to be a better risk indicator for relapses in male patients.
The use of SNRIs in depressed male patients with moderate alcohol intake should be carefully considered, as they might be susceptible to higher risks of relapse compared to alternative antidepressant therapies.
虽然抑郁症可能与多种合并症相关，但抑郁症与肝损伤之间的关联会显著增加死亡风险。本研究的目的是评估适度饮酒是否会影响接受抗抑郁药单药治疗患者的临床复发率。
我们在30个月的时间里评估了254例患有抑郁症、无其他疾病、接受抗抑郁药单药治疗的患者的临床记录，排除了33例有酒精滥用、酒精中毒或严重认知障碍的患者，并收集分析了他们的病史、用药情况和肝酶值。
在符合纳入标准的221例患者中，78例出现了抑郁症复发。复发率与肝酶水平无关。根据γ-谷氨酰转移酶（GGT）水平和谷草转氨酶/谷丙转氨酶（AST/ALT）比值确定的饮酒量表明，男性的饮酒量高于女性。接受5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）治疗且AST水平升高的患者复发可能性约高9倍，而GGT水平升高的患者复发风险高5.34倍。虽然GGT水平仍是GGT升高男性患者复发的一个指标，但谷丙转氨酶（ALT）而非谷草转氨酶（AST）被证明是男性患者复发更好的风险指标。
对于饮酒适度的男性抑郁症患者，应谨慎考虑使用SNRIs，因为与其他抗抑郁治疗相比，他们可能更容易复发。
