在临床环境下治疗双极性抑郁症的胺/乙胺的有效性和安全性
Mia C Santucci1, Mina Ansari1, Sina Nikayin1
1Yale Depression Research Program, Department of Psychiatry at the Yale School of Medicine and the Yale Psychiatric Hospital, New Haven, Connecticut.
The Journal of clinical psychiatry
|October 3, 2024
概括
在治疗双相情感抑郁症的急性治疗期间,胺和胺没有显示出躁狂/低躁狂. 然而,28.9%的患者在维持期间经历了躁狂症状,这表明需要进一步研究长期安全性.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 双极性障碍 (BD) 是一种严重的精神健康状况,与高发病率和死亡率有关.
- 胺显示出抗抑郁的特性,但其在双极性抑郁症中的使用是研究不足的,特别是在现实世界中.
- 有限的数据存在关于胺和胺对双极性抑郁症的疗效和安全性.
研究的目的:
- 为了评估在治疗不耐治疗的双极性抑郁症患者中胺和胺治疗的现实世界结果.
- 评估与这些治疗相关的疗效和安全性,包括躁狂/低躁狂转换的风险.
主要方法:
- 一组45名患有治疗不耐治疗的双极性抑郁症的患者接受了静脉注射 (IV) 胺或鼻内注射 (IN) 胺.
- 诊断是基于DSM标准,临床结果是从医疗记录中提取的.
- 用响应 (≥50%的MADRS改善) 和缓解 (≤10的MADRS) 率来衡量有效性;安全性侧重于躁狂/躁狂症状.
主要成果:
- 在完成急性治疗的38名患者中,39%的患者有反应,13.2%的患者有缓解,MADRS得分平均降低38.3%.
- 在急性治疗阶段 (4周每周两次) 没有发生躁狂/低躁狂.
- 在维持期间,在45名患者中,有28.9%的患者出现了躁狂/低躁狂症状,其中有一次严重事件需要住院治疗.
结论:
- 对双极性抑郁症的胺/胺治疗在急性阶段没有诱导躁狂/低躁狂.
- 很大一部分患者在维持治疗期间经历了情感转换,需要进一步调查.
- 长期的安全性和在双相抑郁症中使用胺/胺的情感转换风险需要进一步的研究.
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