Masi G, Marcheschi M, Pfanner P
Institute of Developmental Neurology, Psychiatry and Educational Psychology, University of Pisa, Italy.
J Intellect Disabil Res. 1997 Jun;41 ( Pt 3):268-72.
The aim of this study was to evaluate the efficacy and side-effects of paroxetine treatment in adolescents with mild intellectual disability and major depressive disorder (MDD). Seven adolescents (14.7-18.4 years of age) were treated with paroxetine (dosage 20-40 mg day-1). Clinical changes were assessed at the beginning of the pharmacological treatment and after 9 weeks utilizing the DSM-IV diagnostic criteria and the Montgomery-Asberg Depression rating Scale (MADRS). Four out of the seven subjects did not fulfil the DSM-IV diagnostic criteria after the 9-week treatment. The mean decrease in the total score on the MADRS was significant (41%). Some items of the MADRS showed significant improvement: inner tension (66%); lassitude (55%); apparent sadness (53%); inability to feel (44%); and reported sadness (43%). Three subjects showed sedation, two subjects gastrointestinal complaints and one subject insomnia; all these symptoms were transitory and not severe. No behavioural activation was evident. This preliminary, uncontrolled study of a few cases suggests that adolescents with intellectual disability and MDD may respond to paroxetine, and that adverse side-effects are mild.
本研究旨在评估帕罗西汀治疗轻度智力残疾伴重度抑郁症（MDD）青少年的疗效及副作用。7名青少年（年龄14.7 - 18.4岁）接受了帕罗西汀治疗（剂量为每日20 - 40毫克）。在药物治疗开始时及9周后，依据《精神疾病诊断与统计手册》第四版（DSM-IV）诊断标准和蒙哥马利-艾斯伯格抑郁评定量表（MADRS）对临床变化进行评估。9周治疗后，7名受试者中有4名未达到DSM-IV诊断标准。MADRS总分的平均降幅显著（41%）。MADRS的一些项目显示出显著改善：内心紧张（66%）；疲倦（55%）；明显悲伤（53%）；情感麻木（44%）；以及自述悲伤（43%）。3名受试者出现镇静作用，2名受试者有胃肠道不适，1名受试者有失眠症状；所有这些症状均为暂时性且不严重。未观察到明显的行为激活现象。这项对少数病例进行的初步、非对照研究表明，智力残疾伴MDD的青少年可能对帕罗西汀有反应，且副作用轻微。
