Gerstman B B, Jolson H M, Bauer M, Cho P, Livingston J M, Platt R
Department of Health Science, San Jose State University, California 95192-0052, USA.
J Clin Epidemiol. 1996 Jul;49(7):809-15. doi: 10.1016/0895-4356(96)00017-0.
We studied the occurrence of depression in new users of propranolol (n = 704), other beta-blockers (n = 587), angiotensin-converting enzyme inhibitors (n = 976), calcium channel blockers (n = 742), and diuretics (n = 773) in the Harvard Community Health Plan population. The period of the study was from April 1988 to June 1991. All study subjects were followed for new or newly recurrent depression for up to 6 months after receiving their first study prescription. Case status was confirmed by blinded medical record review. We found 10 cases of depression that met DSM-III-R criteria ("major depression") and an additional 18 cases that had one or more symptoms consistent with depression ("minor depression"). Rates of major depression in users of beta-blockers and users of non-beta-blocker study drugs were 5.8 per 1000 person-years of exposure and 9.6 per 1000 person-years, respectively. None of the cases of major depression was propranolol associated. Rates of major or minor depression (combined) in users of beta-blockers and users of non-beta-blockers were 20.2 per 1000 person-years and 25.2 per 1000 person-years, respectively. The age- and sex-adjusted relative risk of major or minor depression associated with the use of beta-blockers compared to non-beta-blockers was 0.8 (95% CI, 0.3-1.9). The relative risk associated with propranolol compared to non-beta-blockers was also 0.8 (95% CI, 0.1-2.7). Therefore, depression occurred no more frequently in beta-blocker users than in other members of the study base.
我们在哈佛社区健康计划人群中，研究了心得安新使用者（n = 704）、其他β受体阻滞剂使用者（n = 587）、血管紧张素转换酶抑制剂使用者（n = 976）、钙通道阻滞剂使用者（n = 742）和利尿剂使用者（n = 773）中抑郁症的发生情况。研究时间段为1988年4月至1991年6月。所有研究对象在接受首张研究处方后，被随访长达6个月，观察新的或新复发的抑郁症情况。病例状态通过盲法病历审查得以确认。我们发现10例符合DSM-III-R标准的抑郁症（“重度抑郁症”）病例，另有18例有一项或多项与抑郁症相符症状的病例（“轻度抑郁症”）。β受体阻滞剂使用者和非β受体阻滞剂研究药物使用者中重度抑郁症的发生率分别为每1000人年暴露5.8例和每1000人年9.6例。重度抑郁症病例中无一例与心得安相关。β受体阻滞剂使用者和非β受体阻滞剂使用者中重度或轻度抑郁症（合并）的发生率分别为每1000人年20.2例和每1000人年25.2例。与非β受体阻滞剂相比，使用β受体阻滞剂相关的重度或轻度抑郁症的年龄和性别调整相对风险为0.8（95%可信区间，0.3 - 1.9）。与非β受体阻滞剂相比，心得安相关的相对风险也为0.8（95%可信区间，0.1 - 2.7）。因此，β受体阻滞剂使用者中抑郁症的发生频率并不高于研究人群中的其他成员。
