Efficacy of Fluoxetine for Post-Ischemic Stroke Depression in Tanzania.
Efficacy of Fluoxetine for Post-Ischemic Stroke Depression in Tanzania.
复制标题
DOI：
10.1016/j.jstrokecerebrovasdis.2021.106181
复制
发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Mateen FJ
中科院分区：
文献类型：
--
作者：
Rice DR;Okeng'o K;Massawe E;Ismail S;Mworia NA;Chiwanga F;Kapina B;Wasserman M;Mateen FJ
卒中后氟西汀试验主要在高收入国家进行。我们在坦桑尼亚城市研究中描述了氟西汀治疗和未治疗的缺血性卒中后抑郁的特征。在坦桑尼亚Muhimbili国立医院招募CT证实的急性缺血性卒中发作14天内的成人（>18岁）。在II期试验中，氟西汀治疗组每天服用20 mg氟西汀，持续90天，并与氟西汀未治疗的历史对照组进行比较。主要结局是90天时的抑郁，通过患者健康问卷-9（PHQ-9）进行测量。PHQ-9评分进行了比较氟西汀治疗组和未治疗组。评分>=9分被认为反映抑郁。多变量线性回归模型评估与卒中后PHQ-9评分的相关性。在氟西汀治疗（n=27）和未治疗（n=32）的参与者中，平均年龄为56.8岁（39%女性，100%黑人/非洲人）。平均NIHSS评分为12.1分，改良兰金量表（mRS）评分为3.5分。90天随访时的平均mRS评分为2.3。氟西汀治疗组（平均值=4.1分，标准差=3.2; 11%抑郁）和未治疗组（平均值= 4.4，标准差=4.8; 19%抑郁）的90天PHQ-9评分无显著差异，p= 0.69。在多变量分析中，年龄较大（β=0.08，p= 0.03）和NIHSS评分较高（β=0.15，p= 0.04），但氟西汀（β=0.57，p= 0.59）和性别（β=-0.51，p= 0.63）均与更多抑郁症状显著相关。我们的研究结果与来自高收入人群的试验平行，即氟西汀不能显著改善缺血性卒中后抑郁，尽管我们的样本量很小。需要更多的工作来描述撒哈拉以南非洲中风后抑郁的纵向性质和治疗。
Post-stroke fluoxetine trials are primarily conducted in high-income countries. We characterize post-ischemic stroke depression in fluoxetine-treated and -untreated study participants in urban Tanzania. Adults (>18 years old) within 14 days of CT-confirmed acute ischemic stroke onset were enrolled at Muhimbili National Hospital, Tanzania. The fluoxetine-treated group took 20mg fluoxetine daily for 90 days in a phase II trial and were compared to fluoxetine-untreated historical controls. The primary outcome was depression at 90 days, measured by the Patient Health Questionnaire-9 (PHQ-9). PHQ-9 scores were compared between fluoxetine-treated and -untreated groups. A score >=9 points was considered to reflect depression. A multivariable linear regression model assessed associations with post-stroke PHQ-9 scores. Of the fluoxetine-treated (n=27) and -untreated (n=32) participants, the average age was 56.8 years old (39% women, 100% Black/African). The average presentation NIHSS score was 12.1 points and modified Rankin Scale (mRS) score was 3.5. The average mRS score at 90-day follow-up was 2.3. There was no significant difference between 90-day PHQ-9 scores in the fluoxetine-treated (mean=4.1 points, standard deviation=3.2; 11% depression) and untreated (mean=4.4, standard deviation=4.8; 19% depression) groups, p=.69. In the multivariable analysis, older age (β=0.08, p=.03) and higher NIHSS score (β=0.15, p=.04), but neither fluoxetine (β=0.57, p=.59) nor sex (β=−0.51, p=.63), were significantly associated with more depressive symptoms. Our findings parallel trials from higher income settings that fluoxetine does not significantly improve post-ischemic stroke depression, although our sample size was small. More work is needed to depict the longitudinal nature and treatment of post-stroke depression in Sub-Saharan Africa.
登录
查看更多内容
影响因子：
48
作者：
Hankey, Graeme J.;Hackett, Maree L.;Yi, Qilong
通讯作者：
Yi, Qilong
影响因子：
2.6
作者：
Regenhardt, Robert W.;Biseko, Maijo R.;Okeng'o, Kigocha
通讯作者：
Okeng'o, Kigocha
影响因子：
4.4
作者：
Vogel, Andre C.;Okeng'o, Kigocha;Mateen, Farrah J.
通讯作者：
Mateen, Farrah J.
DOI：
10.2190/8w7y-0tpm-jvgv-qw6m
发表时间：
2006-01-01
影响因子：
2
作者：
Omoro, S. A. O.;Fann, J. R.;Yueh, B.
通讯作者：
Yueh, B.
影响因子：
29
作者：
Almeida, Osvaldo P.;Hankey, Graeme J.;Hackett, Maree
通讯作者：
Hackett, Maree