Cornelius J R, Salloum I M, Ehler J G, Jarrett P J, Cornelius M D, Perel J M, Thase M E, Black A
Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pa, USA.
Arch Gen Psychiatry. 1997 Aug;54(8):700-5. doi: 10.1001/archpsyc.1997.01830200024004.
The selective serotonergic medication fluoxetine has demonstrated efficacy in the treatment of major depression and has suggested efficacy in the treatment of alcoholism. However, no completed trials with any selective serotonergic medication have been reported in patients who display both major depression and alcoholism, despite previous observations that both depression and alcoholism are associated with low serotonergic functioning.
Fifty-one patients diagnosed as having comorbid major depressive disorder and alcohol dependence were randomized to receive fluoxetine (n = 25) or placebo (n = 26) in a 12-week, double-blind, parallel-group trial. Weekly ratings of depression and alcohol consumption were obtained throughout the 12-week course of the study.
The improvement in depressive symptoms during the medication trial was significantly greater in the fluoxetine group than in the placebo group. Total alcohol consumption during the trial was significantly lower in the fluoxetine group than in the placebo group.
Fluoxetine is effective in reducing the depressive symptoms and the alcohol consumption of patients with comorbid major depressive disorder and alcohol dependence. It is unknown whether these results generalize to the treatment of less depressed and less suicidal alcoholics.
选择性5-羟色胺能药物氟西汀已证明对重度抑郁症有效,且有证据表明对酒精中毒也有疗效。然而,尽管先前观察到抑郁症和酒精中毒都与5-羟色胺能功能低下有关,但尚未有关于同时患有重度抑郁症和酒精中毒患者使用任何选择性5-羟色胺能药物的完整试验报告。
在一项为期12周的双盲平行组试验中,51名被诊断为患有重度抑郁症合并酒精依赖的患者被随机分为两组,分别接受氟西汀治疗(n = 25)或安慰剂治疗(n = 26)。在整个12周的研究过程中,每周对抑郁症状和酒精摄入量进行评估。
在药物试验期间,氟西汀组的抑郁症状改善程度明显大于安慰剂组。试验期间,氟西汀组的总酒精摄入量明显低于安慰剂组。
氟西汀对减轻患有重度抑郁症合并酒精依赖患者的抑郁症状和酒精摄入量有效。这些结果是否适用于病情较轻、自杀倾向较低的酒精中毒患者尚不清楚。