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西来赞用于焦虑、抑郁及相关障碍:药理学背景与临床数据。

Silexan in anxiety, depression, and related disorders: pharmacological background and clinical data.

作者信息

Kasper Siegfried, Eckert Anne

机构信息

Department of Molecular Neuroscience, Center of Brain Research, Medical University of Vienna, Spitalgasse 4, Vienna, A-1090, Austria.

Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Basel, Switzerland.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2024 Oct 25. doi: 10.1007/s00406-024-01923-8.

Abstract

We present a narrative review of clinical trials investigating the anxiolytic and antidepressant effects of silexan, an active substance derived from lavender oil and summarize nonclinical findings from pharmacological studies supporting its therapeutic use. Six studies investigated the efficacy of the lavender oil in patients with subthreshold and generalized anxiety disorders as well as in mixed anxiety and depressive disorder (MADD). Furthermore, we present data indicating that silexan may influence sleep quality as well as anxiety or depressive disorders in individuals with post-COVID-19. Silexan taken orally at a daily dose of 80 mg for 10 weeks was significantly superior to placebo in reducing psychic and somatic symptoms of anxiety and was as effective as 0.5 mg/d lorazepam and 20 mg/d paroxetine. In patients with mild or moderate major depression, silexan was superior to placebo and comparably effective to 50 mg/d sertraline. Significant antidepressant effects were also observed in MADD and depression co-morbid with anxiety. The herbal product had a beneficial effect on activities of daily living and health-related quality of life. Adverse events associated with silexan in clinical trials were limited to eructation and mild, transient gastrointestinal complaints. The herbal product was not associated with drug interactions, sedation, sleep disturbance, dependence and abuse potential, sexual dysfunction, weight gain or withdrawal symptoms. Silexan was therefore safe and effective in subthreshold and syndromal anxiety disorders and in major depression.

摘要

我们对研究silexan(一种从薰衣草油中提取的活性物质)抗焦虑和抗抑郁作用的临床试验进行了叙述性综述,并总结了支持其治疗用途的药理学研究的非临床研究结果。六项研究调查了薰衣草油对亚阈值焦虑症和广泛性焦虑症患者以及混合性焦虑和抑郁症(MADD)患者的疗效。此外,我们提供的数据表明,silexan可能会影响新冠病毒感染康复者的睡眠质量以及焦虑或抑郁障碍。每日口服80mg silexan,持续10周,在减轻焦虑的精神和躯体症状方面显著优于安慰剂,并且与0.5mg/d的劳拉西泮和20mg/d的帕罗西汀效果相当。在轻度或中度重度抑郁症患者中,silexan优于安慰剂,且与50mg/d的舍曲林效果相当。在MADD以及伴有焦虑的抑郁症中也观察到了显著的抗抑郁作用。该草药产品对日常生活活动和健康相关生活质量有有益影响。在临床试验中,与silexan相关的不良事件仅限于嗳气和轻微、短暂的胃肠道不适。该草药产品与药物相互作用、镇静、睡眠障碍、依赖性和滥用可能性、性功能障碍、体重增加或戒断症状无关。因此,silexan在亚阈值和综合征性焦虑症以及重度抑郁症中是安全有效的。

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