Cornelius J R, Salloum I M, Cornelius M D, Perel J M, Ehler J G, Jarrett P J, Levin R L, Black A, Mann J J
Department of Psychiatry, University of Pittsburgh Medical Center, PA 15213, USA.
Psychopharmacol Bull. 1995;31(2):297-303.
The selective serotonergic agonist fluoxetine has demonstrated efficacy in the treatment of depression and has possible efficacy in the treatment of nondepressed and depressed alcoholics. However, no double-blind, placebo-controlled trials with any selective serotonergic medication have been reported in patients who have both major depression and alcoholism. In this study, 21 patients with DSM-III-R diagnoses of both major depressive disorder and alcohol dependence were randomized to fluoxetine or placebo in a 12-week, double-blind, parallel group trial. The patients reported a high level of current episode (52.4%), prior episode (61.9%), and lifetime (76.2%) suicidal behavior. Total alcohol consumption during the 12-week treatment course was significantly lower in the fluoxetine group than the placebo group, after controlling for baseline differences in consumption. The fluoxetine group demonstrated a four-fold greater improvement in depressive symptoms, but this difference did not reach statistical significance in this small sample. These preliminary findings suggest that fluoxetine has potential for treating the excessive alcohol ingestion of depressed alcoholics and may have potential for treating the depressive symptoms of these patients as well.
选择性5-羟色胺能激动剂氟西汀已被证明在治疗抑郁症方面有效，并且在治疗未患抑郁症和患有抑郁症的酗酒者方面可能也有效。然而，尚无关于同时患有重度抑郁症和酗酒症患者使用任何选择性5-羟色胺能药物进行双盲、安慰剂对照试验的报道。在本研究中，21名被诊断为患有重度抑郁症和酒精依赖症（依据《精神疾病诊断与统计手册》第三版修订版标准）的患者，在一项为期12周的双盲平行组试验中被随机分为氟西汀组或安慰剂组。这些患者报告了当前发作期（52.4%）、既往发作期（61.9%）以及终生（76.2%）的自杀行为发生率较高。在控制了饮酒量的基线差异后，氟西汀组在12周治疗疗程中的总饮酒量显著低于安慰剂组。氟西汀组在抑郁症状改善方面显示出四倍于安慰剂组的效果，但在这个小样本中，这种差异未达到统计学意义。这些初步研究结果表明，氟西汀在治疗患有抑郁症的酗酒者过度饮酒方面具有潜力，并且可能在治疗这些患者的抑郁症状方面也具有潜力。
