Fava M, Borus J S, Alpert J E, Nierenberg A A, Rosenbaum J F, Bottiglieri T
Depression Clinical and Research Program, Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114, USA.
Am J Psychiatry. 1997 Mar;154(3):426-8. doi: 10.1176/ajp.154.3.426.
The authors examined the relationships between levels of three metabolites (folate, vitamin B12, and homocysteine) and both depressive subtype and response to fluoxetine treatment in depressed patients.
Fluoxetine, 20 mg/day for 8 weeks, was given to 213 outpatients with major depressive disorder. At baseline, depressive subtypes were assessed, and a blood sample was collected from each patient. Serum metabolite levels were assayed. Response to treatment was determined by percentage change in score on the 17-item Hamilton Depression Rating Scale.
Subjects with low folate levels were more likely to have melancholic depression and were significantly less likely to respond to fluoxetine. Homocysteine and B12 levels were not associated with depressive subtype or treatment response.
Overall, the results are consistent with findings linking low folate levels to poorer response to antidepressant treatment. Folate levels might be considered in the evaluation of depressed patients who do not respond to antidepressant treatment.
作者研究了三种代谢物（叶酸、维生素B12和同型半胱氨酸）水平与抑郁症患者抑郁亚型及对氟西汀治疗反应之间的关系。
对213例重度抑郁症门诊患者给予氟西汀，每日20mg，持续8周。在基线时，评估抑郁亚型，并采集每位患者的血样。检测血清代谢物水平。治疗反应通过17项汉密尔顿抑郁量表评分的百分比变化来确定。
叶酸水平低的受试者更有可能患有 melancholic 抑郁症，且对氟西汀反应的可能性显著降低。同型半胱氨酸和维生素B12水平与抑郁亚型或治疗反应无关。
总体而言，结果与低叶酸水平与抗抑郁治疗反应较差之间的联系的研究结果一致。在评估对抗抑郁治疗无反应的抑郁症患者时，可能需要考虑叶酸水平。
