临床实践中对患有重度抑郁症的儿童和青少年使用伏硫西汀的回顾性分析。
A retrospective analysis of vortioxetine utilization in children and adolescents with major depressive disorder in clinical practice.
作者信息
Luo Xianmei, Yu Shu, Pan Keliang, Cheng Lin, Luo Fan, Zhang Handi, Duan Mingjun, Zhang Yajun
机构信息
MOE Key Lab for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 611731, China.
Mental Health Center of Shantou University, Shantou, 515000, China.
出版信息
BMC Psychiatry. 2025 May 20;25(1):509. doi: 10.1186/s12888-025-06983-1.
BACKGROUND
Treating depression in children and adolescents has always been a challenge in clinical pharmacotherapy. Vortioxetine, as a new type of antidepressant, is considered to have the potential for use in the treatment of depression in children and adolescents. This study aimed to evaluate the usage of vortioxetine and its efficacy and tolerability in children and adolescents with major depressive disorder in a real-world study.
METHODS
A retrospective survey of vortioxetine treatment was conducted at a Class A tertiary mental health hospital. Data regarding the demographic and clinical characteristics were collected among children and adolescents with major depressive disorder from electronic medical record system.
RESULTS
The study included a total of 253 depressive patients, comprising 96 males and 157 females, who were prescribed vortioxetine at any time during the research period. One hundred and twenty-three patients (43.62%) received vortioxetine treatment at the initial visit. Of the total patients, 27 (10.67%) reported side effect, such as nausea, vomiting, dizziness, palpitations, diarrhea, drowsiness, and itching. Additionally, 20 (7.91%) discontinued medical treatment due to adverse effect. No significant difference was found between males and females in drug-related adverse events (X = 0.56, P = 0.454). Furthermore, 96 (37.94%) reported relief from their symptoms in all patients, with a significant difference observed between males and females in reporting symptom relief (X = 3.934, P = 0.047). But this difference disappeared in patients who took vortioxetine alone and those who took it for more than three months.
CONCLUSION
There exists a certain proportion of children and adolescents suffering from depression who are prescribed vortioxetine in an off-label manner in psychiatric clinics. Vortioxetine demonstrates well tolerability in clinical practice. However, the proportion of self-report symptom alleviation is comparatively unsatisfactory. Furthermore, gender appears influence on self-report symptom relief.
背景
儿童和青少年抑郁症的治疗一直是临床药物治疗中的一项挑战。伏硫西汀作为一种新型抗抑郁药，被认为有用于治疗儿童和青少年抑郁症的潜力。本研究旨在通过一项真实世界研究评估伏硫西汀在重度抑郁症儿童和青少年中的使用情况及其疗效和耐受性。
方法
在一家三级甲等精神卫生医院对伏硫西汀治疗进行回顾性调查。从电子病历系统收集重度抑郁症儿童和青少年的人口统计学和临床特征数据。
结果
该研究共纳入253例抑郁症患者，其中男性96例，女性157例，在研究期间的任何时间均接受了伏硫西汀治疗。123例患者（43.62%）在初诊时接受了伏硫西汀治疗。在所有患者中，27例（10.67%）报告了副作用，如恶心、呕吐、头晕、心悸、腹泻、嗜睡和瘙痒。此外，20例（7.91%）因不良反应停药。药物相关不良事件在男性和女性之间未发现显著差异（X = 0.56，P = 0.454）。此外，所有患者中有96例（37.94%）报告症状缓解，在报告症状缓解方面男性和女性之间存在显著差异（X = 3.934，P = 0.047）。但这种差异在单独服用伏硫西汀的患者和服用超过三个月的患者中消失。
结论
在精神科门诊中，有一定比例的抑郁症儿童和青少年以非适应证方式使用伏硫西汀。伏硫西汀在临床实践中显示出良好的耐受性。然而，自我报告症状缓解的比例相对不令人满意。此外，性别似乎对自我报告症状缓解有影响。
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