鞘内注射促甲状腺素释放激素（普罗瑞林）对难治性抑郁症患者的影响。
Effects of intrathecal thyrotropin-releasing hormone (protirelin) in refractory depressed patients.
作者信息
Marangell L B, George M S, Callahan A M, Ketter T A, Pazzaglia P J, L'Herrou T A, Leverich G S, Post R M
机构信息
Biological Psychiatry Branch, National Institutes of Mental Health, Bethesda, Md, USA.
出版信息
Arch Gen Psychiatry. 1997 Mar;54(3):214-22. doi: 10.1001/archpsyc.1997.01830150034007.
BACKGROUND
Therapeutic effects of the tripeptide protirelin (thyrotropin-releasing hormone) have been postulated in the affective disorders, but direct assessment in humans has been hindered by poor blood-brain barrier permeability.
METHODS
Eight medication-free inpatients with refractory depression received 500 micrograms of protirelin via a lumbar intrathecal injection and an identical sham lumbar puncture procedure, separated by 1 week, in a double-blind crossover design.
RESULTS
Five of eight patients responded to intrathecal protirelin, defined as a 50% or greater reduction in an abbreviated Hamilton Rating Scale for Depression score. Suicidality also was reduced significantly (P < .05). Responses were rapid and clinically robust, but short-lived.
CONCLUSION
Administration of protirelin by an intrathecal route induced a rapid improvement in mood and suicidality in these refractory depressed patients, supporting the hypothesis that thyrotropin-releasing hormone could be a positive modulator of mood.
背景
三肽促甲状腺素释放激素在情感障碍中的治疗作用已被提出，但由于血脑屏障通透性差，在人体中的直接评估受到阻碍。
方法
8例未服用药物的难治性抑郁症住院患者，采用双盲交叉设计，先通过腰椎鞘内注射给予500微克促甲状腺素释放激素，1周后进行相同的假腰椎穿刺操作。
结果
8例患者中有5例对鞘内注射促甲状腺素释放激素有反应，定义为汉密尔顿抑郁量表简表评分降低50%或更多。自杀倾向也显著降低（P<0.05）。反应迅速且临床上显著，但持续时间短。
结论
鞘内注射促甲状腺素释放激素可使这些难治性抑郁症患者的情绪和自杀倾向迅速改善，支持促甲状腺素释放激素可能是情绪的正向调节因子这一假说。
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