Salín-Pascual R J, Rosas M, Jimenez-Genchi A, Rivera-Meza B L, Delgado-Parra V
Hospital Psiquiatrico Fray Bernardino Alvarez, Secretaria de Salud, Universidad Nacional Autonoma de Mexico, Mexico City.
J Clin Psychiatry. 1996 Sep;57(9):387-9.
A high frequency of cigarette smoking has been reported among individuals with major depression. In a previous study, transdermal nicotine produced short-term improvement in the mood of depressed patients. This study was undertaken to determine the effects of 4 days' administration of transdermal nicotine on mood in nonsmoking patients with major depression.
The effects of nicotine patches (17.5 mg) on 12 nonmedicated outpatients with major depression (DSM-III-R) were studied for 4 continuous days. Patients had to score 18 points or more on the Hamilton Rating Scale for Depression (HAM-D) (21 items) for admission into the study. The HAM-D (10 items), a visual analog scale, and a side effects scale were scored daily during the trial (baseline, 4 days of nicotine patches, and 4 days of follow-up).
Two patients dropped out of the study owing to nausea and vomiting. Results of the visual analog scale and HAM-D (10 items) showed a significant (p < .01) improvement in depression after the second day of nicotine patches. Patients relapsed 3 or 4 days after the last nicotine dose. The side effects observed were an increase in saliva production, nausea, loss of appetite, and mild insomnia.
Nicotine patches produced short-term improvement of depression with minor side effects. Because of nicotine's high risk to health, nicotine patches are not recommended for clinical use in depression. Analogue drugs may be developed in the future that may help improve depression without the risk of other major health problems.
据报道，重度抑郁症患者中吸烟频率较高。在之前的一项研究中，经皮尼古丁可使抑郁症患者的情绪得到短期改善。本研究旨在确定对重度抑郁症非吸烟患者连续4天给予经皮尼古丁对情绪的影响。
对12名未接受药物治疗的重度抑郁症（DSM-III-R）门诊患者连续4天研究尼古丁贴片（17.5毫克）的效果。患者在汉密尔顿抑郁量表（HAM-D）（21项）上得分必须达到18分或更高才能纳入研究。在试验期间（基线、4天尼古丁贴片治疗期和4天随访期）每天对HAM-D（10项）、视觉模拟量表和副作用量表进行评分。
两名患者因恶心和呕吐退出研究。视觉模拟量表和HAM-D（10项）的结果显示，在使用尼古丁贴片第二天后抑郁症状有显著改善（p <.01）。在最后一剂尼古丁后3或4天患者病情复发。观察到的副作用有唾液分泌增加、恶心、食欲不振和轻度失眠。
尼古丁贴片可使抑郁症得到短期改善且副作用较小。由于尼古丁对健康有高风险，不建议在抑郁症临床治疗中使用尼古丁贴片。未来可能会研发出类似药物，有助于改善抑郁症且无其他重大健康问题风险。
