轻度至中度重度主要抑郁症的早期增强疗法:一组顺序性,响应适应性随机对照试验
Shampa Maji1, Archana Mishra1, Debadatta Mohapatra2
1Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India.
Psychiatry research
|November 17, 2024
概括
添加德克斯特罗梅索芬可显著改善症状,反应和缓解率在患有重大抑郁症 (MDD) 的患者,当添加到SSRI. 这种NMDA对抗剂显示出安全有效的MDD治疗的前景.
科学领域:
- 神经科学是一个神经科学.
- 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:
- 大型抑郁症 (MDD) 带来了诸多挑战,包括治疗延迟,缺乏反应和不良药物反应.
- 胺的成功凸显了对NMDA抗剂进行进一步研究的需要,以获得安全和长期的MDD疗法.
研究的目的:
- 评估德克斯特罗梅索芬作为SSRI的辅助治疗在MDD患者中的疗效和安全性.
主要方法:
- 一个随机,双盲,安慰剂对照试验,涉及60名MDD患者.
- 参与者接受了30毫克德克斯特罗梅索芬或安慰剂作为SSRI的辅助剂,持续了8周.
- 主要结局:MADRS得分的变化;次要结局:反应/缓解率,CGI-S/I得分,血清BDNF和血清德克斯特罗梅索芬水平.
主要成果:
- 添加德克斯特罗梅索芬显著降低了MADRS得分 (p < 0.001),并改善了CGI-S (p = 0.002) 和CGI-I (p = 0.001) 的得分.
- 在德克斯特罗梅索芬组观察到更高的响应率 (p = 0.008) 和缓解率 (p = 0.007).
- 血清BDNF水平没有发现显著差异;不良事件在两组之间是可比的.
结论:
- 辅助德克斯特罗梅索芬 (30毫克/天) 可能显著改善轻度至中度MDD的临床结果.
- 这种增强策略显示出增强症状改善,反应和缓解率的潜力.
- 对于MDD治疗,需要对NMDA抗剂如德克斯特罗梅索芬进行进一步的研究.
相关概念视频
01:23Antidepressant Drugs: MAOIs and Other Agents
195
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
195
01:30Electroconvulsive Therapy
25
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
25
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
146
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
146
01:28Drug Therapy
39
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
39
01:27Depressive Disorders: MDD and Dysthymia
61
Depressive disorders are a group of mental health conditions characterized by pervasive feelings of sadness, diminished pleasure in life, and a significant impact on daily functioning. These conditions are most prevalent in individuals during their 30s and affect women at twice the rate of men. Contrary to popular belief, younger individuals are generally more susceptible to these disorders than older adults. Two key types of depressive disorders include Major Depressive Disorder (MDD) and...
61
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
232
Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
232