度洛西汀对重度抑郁症认知增强作用的见解。
Insights on the cognitive enhancement effect of desvenlafaxine in major depressive disorder.
作者信息
Vicent-Gil Muriel, Trujols Joan, Sagués Teresa, Serra-Blasco Maria, Navarra-Ventura Guillem, Mantellini Cecilia Lucía, Crivillés Sara, Portella Maria J, Cardoner Narcís
机构信息
Sant Pau Mental Health, Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain.
Hospital de la Sant Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025, Barcelona, Spain.
出版信息
Ann Gen Psychiatry. 2025 Mar 19;24(1):16. doi: 10.1186/s12991-025-00552-2.
BACKGROUND
Desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor, has demonstrated efficacy in improving affective symptoms of Major Depressive Disorder (MDD); however, its effects on associated cognitive and functional difficulties remain underexplored. This study seeks to assess the antidepressant effects of desvenlafaxine in patients with SSRI-resistant MDD, its impact on both objective and subjective cognitive performance, where cognitive improvements occur independently of clinical recovery or not, and its influence on psychosocial functioning.
METHODS
An observational case-control prospective study with 66 participants was conducted, including 26 patients with a current MDD episode, with an inadequate SSRI response, and with the prescription of desvenlafaxine as the next antidepressant therapeutic option, and 40 healthy controls. Sociodemographic, clinical, cognitive, and functional assessments were conducted both before and after a 12-week treatment period. Changes were analyzed using two tailed paired-samples t-tests, with Cohen's d for effect sizes. Cognitive improvements were compared between the patients who achieved remission and those who did not.
RESULTS
Patients showed significant improvements in depressive and anxiety symptoms, attention/working memory and processing speed, self-perceived cognitive difficulties and psychosocial functioning. Highlighting the fact these cognitive enhancements occurred independently of patients' clinical improvement.
CONCLUSIONS
The findings of this study focus on the therapeutic potential of desvenlafaxine, demonstrating its efficacy not only in ameliorating clinical and functional symptoms but also in addressing specific cognitive impairments in patients with depression. Further research is needed to elucidate the mechanisms underlying desvenlafaxine's effects and optimize treatment strategies for individuals with MDD.
TRIAL REGISTRATION NUMBER
NCT03432221 (clinical.
TRIALS
gov). Registration date: 08-01-2018.
背景
度洛西汀是一种5-羟色胺-去甲肾上腺素再摄取抑制剂，已证明其在改善重度抑郁症（MDD）的情感症状方面具有疗效；然而，其对相关认知和功能障碍的影响仍未得到充分研究。本研究旨在评估度洛西汀对选择性5-羟色胺再摄取抑制剂（SSRI）抵抗的MDD患者的抗抑郁作用，其对客观和主观认知表现的影响（无论认知改善是否独立于临床康复），以及其对心理社会功能的影响。
方法
进行了一项观察性病例对照前瞻性研究，共有66名参与者，包括26名当前患有MDD发作、对SSRI反应不足且将度洛西汀作为下一种抗抑郁治疗选择的患者，以及40名健康对照者。在为期12周的治疗期前后进行了社会人口统计学、临床、认知和功能评估。使用双尾配对样本t检验分析变化情况，并计算效应量的Cohen's d值。比较了达到缓解的患者和未达到缓解的患者之间的认知改善情况。
结果
患者在抑郁和焦虑症状、注意力/工作记忆和处理速度、自我感知的认知困难以及心理社会功能方面均有显著改善。突出表明这些认知增强是独立于患者的临床改善而发生的。
结论
本研究结果聚焦于度洛西汀的治疗潜力，证明其不仅在改善临床和功能症状方面有效，而且在解决抑郁症患者的特定认知障碍方面也有效。需要进一步研究以阐明度洛西汀作用的潜在机制，并优化MDD患者的治疗策略。
试验注册号
NCT03432221（clinicaltrials.gov）。注册日期：2018年1月8日。
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