在患有抑郁症的患者中,通过手术麻醉掩盖胺的随机试验
Theresa R Lii1, Ashleigh E Smith1, Josephine R Flohr1
1Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Nature. Mental health
|January 8, 2024
概括
一项研究发现,静脉注射胺,当被手术麻醉掩盖时,与安慰剂相比,在患有严重抑郁症的成年人中没有显著的抗抑郁作用. 掩盖策略是有效的,但不适合一般使用.
科学领域:
- 精神病学是一个精神病学.
- 麻醉学 麻醉学
- 临床药理学 临床药理学
背景情况:
- 胺具有潜在的抗抑郁药物特性,但其精神活性效应挑战了安慰剂对照试验的掩盖.
- 有效的掩盖对于对具有急性精神活性作用的新型抗抑郁药物的公正评估至关重要.
研究的目的:
- 在接受例行手术的患有严重抑郁症的患者中,评估静脉注射基他胺被手术麻醉掩盖的抗抑郁药的疗效.
- 为了评估使用手术麻醉来隐藏胺剂的三重掩护的成功.
主要方法:
- 一个单中心,并行臂,三重掩护,随机,安慰剂对照试验 (NCT03861988) 涉及40名患有严重抑郁症的成年患者.
- 参与者在麻醉期间接受了单次输注胺 (0.5 mg/kg) 或安慰剂 (盐水).
- 抑郁症的严重程度使用蒙哥马利-阿斯伯格抑郁症评分表 (MADRS) 测量在输液后的1,2,3天.
主要成果:
- 在胺和安慰剂组之间没有观察到抑郁症严重程度的统计学上显著差异 (p=0.13).
- 36.8%的参与者正确猜测了他们的治疗分配,表明成功掩盖.
- 使用外科麻醉的掩护策略是有效的,但被认为对于更广泛的应用是不切实际的.
结论:
- 与安慰剂相比,在手术麻醉期间给予静脉注射单剂量的胺没有显示出急性抗抑郁药的有效性.
- 这项研究成功地使用了手术麻醉来掩盖胺剂的使用,强调了在精神活性化合物的试验中盲目的重要性.
- 对新型抗抑郁药的未来研究应该优先考虑强大的掩盖策略,以减轻预期偏差.
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