与阿曼塔丁与普拉米佩克索尔抗抑郁剂增强剂在治疗耐药单极性抑郁症中的比较疗效:一项随机对照试验
Biswa Ranjan Mishra1, Debadatta Mohapatra1, Tathagata Biswas1
1Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
Journal of affective disorders
|July 14, 2025
概括
普拉米醇和阿曼塔丁是安全有效的治疗治疗耐药性抑郁症 (TRD) 的治疗方法,当增强塞特拉林时. 与阿曼塔丁和奎平相比,普拉米佩克索尔的疗效优于阿曼塔丁和奎平,所有疗法都改善了神经营养因素.
科学领域:
- 神经科学和精神病学 在
- 药理增强策略 药理增强策略
背景情况:
- 耐治疗抑郁症 (TRD) 的增强选择有限,主要是非典型的抗精神病药物.
- 对TRD的新兴神经生物学见解需要对新药类进行调查.
- 这项研究探讨了阿曼塔丁 (NMDA抗剂) 和普拉米醇 (多巴胺激动剂) 作为TRD的增强疗法.
研究的目的:
- 为了比较阿曼塔丁和普拉米佩克索尔作为TRD增强剂的疗效和安全性,与奎平相比.
- 评估这些增强策略对血清神经营养因子的影响,包括来自大脑的神经营养因子 (BDNF) 和神经生长因子 (NGF).
主要方法:
- 一个开放的标签试验随机选择了150名TRD患者,用塞特拉林加上阿曼塔丁 (每天200毫克),普拉米佩克索尔 (每天0.375毫克) 或奎蒂亚平 (每天100毫克) 进行增强.
- 临床评估包括汉密尔顿抑郁评分表 (HAM-D21) 和临床全球印象 (CGI) 尺度在基线,4周和8周.
- 在基线,4周和8周测量血清BDNF和NGF水平,以评估神经营养变化.
主要成果:
- 所有三个增强组都在8周内显著降低了HAM-D和CGI-Severity分数.
- 与阿曼塔丁和奎平相比,普拉米佩克索尔在4周和8周的所有临床测量中显示出明显优于阿曼塔丁和奎平的疗效.
- 阿曼塔丁和奎蒂亚平的疗效相似,所有组都报告了类似的不良事件概况. 神经损伤因子水平在群体内显著增加,群体之间没有显著差异.
结论:
- 用阿曼塔丁和普拉米佩克索尔增加TRD是一种安全有效的策略.
- 与阿曼塔丁和奎平相比,普拉米佩克索尔在这种TRD增强环境中提供了更高的疗效.
- 观察到的临床改善与增强的BDNF和NGF水平相关,尽管需要更大的多中心研究来进行更广泛的验证.
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