McGrath P J, Stewart J W, Quitkin F M, Wager S, Jenkins S W, Archibald D G, Stringfellow J C, Robinson D S
Depression Evaluation Service, New York State Psychiatric Institute, NY 10032.
J Clin Psychopharmacol. 1994 Oct;14(5):347-52.
This is a report of a controlled trial of gepirone, a 5-hydroxytryptamine (5-HT1A) partial agonist azapirone related to buspirone, in the treatment of atypical depression. The azapirones are of particular interest because their highly selective actions on the serotonergic system may possibly make them useful pharmacologic probes and potentially selective therapeutic agents. Sixty outpatients meeting Columbia criteria for definite or probable atypical depression were enrolled in a double-blind, randomized, placebo-controlled, 8-week clinical trial at a single site. The dosage schedule was fixed flexible, with 10-mg capsules given on a thrice-daily schedule, with doses of up to 120 mg daily. The response rate at 8 weeks for the intention-to-treat sample analyzed with the last observation carried forward was 62% (18 of 29 patients) for gepirone and 20% (6 of 30 patients) for placebo (chi 2 = 9.1; df = 1; p < 0.001). Robust and consistent drug-placebo differences are seen across virtually all rating scales post-treatment. The effect of gepirone was consistent across the levels of concomitant variables, including duration of episode and presence of dysthymia or panic. Gepirone is a novel antidepressant that holds promise for the treatment of atypical depression and that may be of heuristic value because of its relatively specific actions on the serotonergic system.
这是一篇关于吉哌隆（一种与丁螺环酮相关的5-羟色胺（5-HT1A）部分激动剂氮杂螺环酮）治疗非典型抑郁症的对照试验报告。氮杂螺环酮特别引人关注，因为它们对血清素能系统具有高度选择性作用，这可能使它们成为有用的药理学探针和潜在的选择性治疗药物。60名符合哥伦比亚明确或可能非典型抑郁症标准的门诊患者在单一地点参加了一项为期8周的双盲、随机、安慰剂对照临床试验。给药方案为固定灵活给药，10毫克胶囊每日三次给药，每日剂量最高可达120毫克。采用末次观察结转法分析意向性治疗样本，8周时吉哌隆的有效率为62%（29例患者中的18例），安慰剂为20%（30例患者中的6例）（卡方 = 9.1；自由度 = 1；p < 0.001）。治疗后几乎所有评分量表上都出现了显著且一致的药物与安慰剂差异。吉哌隆的疗效在伴随变量的各个水平上都是一致的，包括发作持续时间以及是否存在心境恶劣或惊恐症状。吉哌隆是一种新型抗抑郁药，有望用于治疗非典型抑郁症，并且由于其对血清素能系统的相对特异性作用，可能具有启发价值。
