阿片类药物降低了安慰剂抗抑郁药的反应:随机对照胺试验的观察性后期发现
Theresa R Lii1, Josephine R Flohr1, Robin L Okada1
1Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Journal of affective disorders
|April 4, 2025
概括
在手术患者中,阿片类药物的使用削弱了用于治疗抑郁症的安慰剂效应. 然而,胺基因
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 精神病学是一个精神病学.
背景情况:
- 内源性阿片类系统影响抑郁症中安慰剂反应.
- 之前的一项试验在手术患者中发现了显著的安慰剂效应,其中一些患者在慢性阿片类药物治疗中.
- 这建议调查阿片类药物与安慰剂抗抑郁药物的相互作用.
研究的目的:
- 测试基线阿片类药物使用是否影响抗抑郁药对胺或安慰剂的反应.
- 分析了手术患者对胺的随机,安慰剂对照试验的数据.
主要方法:
- 一个随机,麻醉失明,安慰剂受控试验的后期分析.
- 使用混合效应模型来评估基线阿片类药物使用对1至14天治疗后抑郁症得分 (MADRS) 的影响.
主要成果:
- 基线阿片类药物使用显著减少了安慰剂接受者的抑郁症严重程度,但不是胺类药物接受者.
- 这种效应独立于基线抑郁症,疼痛强度和种族.
- 手术后疼痛强度与抑郁症严重程度的相关性很小.
结论:
- 基线阿片类药物使用减弱了抑郁症手术患者的安慰剂抗抑郁药反应,独立于疼痛.
- 静脉注射胺的抗抑郁作用在使用阿片类药物的患者中保持不变.
- 由于样本规模较小,研究结果需要通过前性受控研究进行确认.
相关概念视频
The Placebo Effect
6.1K
The placebo effect occurs when people's expectations or beliefs influence or determine their experience in a given situation. In other words, simply expecting something to happen can actually make it happen.
6.1K
Opioid Analgesics: Synthetic and Semisynthetic Opioids
203
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
203
Blind Procedures
10.6K
Ideally, the people who observe and record the children’s behavior are unaware of who was assigned to the experimental or control group, in order to control for experimenter bias. Experimenter bias refers to the possibility that a researcher’s expectations might skew the results of the study. Remember, conducting an experiment requires a lot of planning, and the people involved in the research project have a vested interest in supporting their hypotheses. If the observers knew which...
10.6K
Analgesia and Pain Management
420
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
420
Antidepressant Drugs: MAOIs and Other Agents
175
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...
175
Opioid Analgesics: Morphine and Other Natural Cogeners
159
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
159


