Flint A J, Rifat S L
Geriatric Psychiatry Program, Toronto Hospital, Ontario, Canada.
J Clin Psychopharmacol. 1994 Oct;14(5):353-6.
This open, prospective study investigated the efficacy of lithium augmentation in elderly patients who had failed to respond to a 6-week course of antidepressant medication. Twenty-one patients (age range, 64 to 88 years) with DSM-III-R unipolar, nonpsychotic major depression refractory to a 6-week course of nortriptyline, fluoxetine, or phenelzine underwent a minimum of 2 weeks of lithium augmentation. Five patients had a complete response, 3 had a partial response, and 13 did not respond. Half of the patients developed dose-limiting side effects, most commonly neuromuscular or neurologic. Patients developing side effects were significantly older (p = 0.05), and there was a tendency for side effects to occur more frequently in patients treated with fluoxetine. The rate of response to lithium augmentation in this elderly population was lower than that reported for most open and controlled studies in younger patients. Possible reasons for this are discussed.
这项开放性前瞻性研究调查了锂盐增效疗法对那些对抗抑郁药物6周疗程无反应的老年患者的疗效。21例（年龄范围为64至88岁）患有DSM-III-R单相、非精神病性重度抑郁症且对去甲替林、氟西汀或苯乙肼6周疗程治疗无效的患者接受了至少2周的锂盐增效治疗。5例患者完全缓解，3例部分缓解，13例无反应。一半的患者出现了剂量限制性副作用，最常见的是神经肌肉或神经系统副作用。出现副作用的患者年龄显著更大（p = 0.05），且在用氟西汀治疗的患者中副作用更倾向于更频繁地出现。该老年人群中锂盐增效治疗的缓解率低于大多数针对年轻患者的开放性和对照研究报告的缓解率。文中讨论了可能的原因。
