Mück-Weymann M, Rechlin T
Department of Psychiatry, Friedrich-Alexander University, Erlangen, Germany.
Psychopharmacology (Berl). 1996 Apr;124(3):241-4. doi: 10.1007/BF02246663.
Cutaneous microcirculation was investigated in 30 major depressed inpatients receiving either 150 mg amitriptyline (n = 15) or 30 mg fluoxetine (n = 15) as monotherapy, and in 15 normal control subjects matched for age and sex. The laser Doppler flux (LDF) was recorded while resting and under the condition of a sudden deep breath ("inspiratory gasp response"). In normal subjects this autonomic function test caused a marked decrement of LDF signal, which rapidly returned to the baseline value. In both groups of drug treated patients the decrements of LDF signal after a sudden deep breath did not differ from those found in the normal control subjects. However, in the amitriptyline-treated patients the return of LDF-signal to the baseline values was significantly delayed (P = 0.0007), while patients treated with fluoxetine showed the same behaviour as normal subjects. With a discriminant analysis using the results of the inspiratory gasp responses, 100% of the amitriptyline treated patients were correctly classified. Since both groups of depressed patients revealed comparable depression scores, the differences found are probably due to the side effects of amitriptyline. Possible clinical implications of these findings are discussed.
对30名接受150毫克阿米替林（n = 15）或30毫克氟西汀（n = 15）单药治疗的重度抑郁症住院患者以及15名年龄和性别匹配的正常对照者的皮肤微循环进行了研究。在静息状态和突然深呼吸（“吸气喘息反应”）条件下记录激光多普勒血流（LDF）。在正常受试者中，这种自主功能测试导致LDF信号显著下降，然后迅速恢复到基线值。在两组接受药物治疗的患者中，突然深呼吸后LDF信号的下降与正常对照者中发现的情况没有差异。然而，在接受阿米替林治疗的患者中，LDF信号恢复到基线值明显延迟（P = 0.0007），而接受氟西汀治疗的患者表现与正常受试者相同。通过使用吸气喘息反应结果进行判别分析，100%的阿米替林治疗患者被正确分类。由于两组抑郁症患者的抑郁评分相当，发现的差异可能归因于阿米替林的副作用。讨论了这些发现可能的临床意义。
