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埃斯基塔洛普拉姆用于阿尔茨海默氏症痴呆症的激发:一个随机对照的第三阶段试验
Tarek K Rajji1,2,3, Sheriza N Baksh4, David M Shade4
1Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. tarek.rajji@utsouthwestern.edu.
Nature medicine
|March 26, 2025
概括
埃斯基塔洛普拉姆在阿尔茨海默氏症痴呆症 (AD) 患者中没有有效治疗激动,尽管它是西塔洛普拉姆的潜在替代品. 该研究还指出,在使用埃斯基塔洛普拉姆时,心脏风险,包括QT间隔延长.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
背景情况:
- 兴奋是阿尔茨海默氏症痴呆症 (AD) 的一个常见症状.
- 西塔洛普拉姆是有效的AD激发,但携带认知和心脏风险.
- 作为一种潜在的更安全的替代品,研究了citalopram的S-enantiomer - - escitalopram.
研究的目的:
- 评估埃斯基塔洛普拉姆在治疗阿尔茨海默氏症痴呆症成年人激动的疗效和安全性.
- 在心理社会干预 (PSI) 失败后评估埃斯基塔洛普拉姆的有效性.
主要方法:
- 这是一项双面罩,随机,安慰剂控制的试验,涉及173名患有AD和兴奋症的参与者.
- 参与者接受了12周的埃斯基塔洛普拉姆 (高达15毫克/天) 或安慰剂,并继续PSI.
- 有效性是通过12周内在激发方面有临床显著改善的参与者比例来衡量的.
主要成果:
- 埃斯基塔洛普拉姆在治疗阿尔茨海默氏症痴呆症患者的激动方面没有被发现是有效的.
- 在12周改善的未经调整的风险差异为0.08 (95% CI: -0.21,0.06).
- 随着埃斯基塔洛普拉姆的使用,观察到心脏导电延迟,包括QT间隔延长.
结论:
- 埃斯基塔洛普拉姆不是阿尔茨海默氏症痴呆症激动的有效治疗方法.
- 在AD患者中使用埃斯基塔洛普拉姆与心脏导电延迟有关.
- 临床医生在考虑使用埃斯基塔洛普拉姆作为治疗AD激发的西塔洛普拉姆替代品时应谨慎行事.
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