A prospective naturalistic study of antidepressant-induced jitteriness/anxiety syndrome.
A prospective naturalistic study of antidepressant-induced jitteriness/anxiety syndrome.
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DOI：
10.2147/ndt.s70637
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发表时间：
2014
影响因子：
3.2
通讯作者：
Ishigooka J
中科院分区：
文献类型：
--
作者：
Harada T;Inada K;Yamada K;Sakamoto K;Ishigooka J
患者在开始服用抗抑郁药后通常会出现神经精神症状，如焦虑和激动，这被认为与潜在的自杀风险增加有关。然而，抗抑郁药引起的神经过敏/焦虑综合征的发病率尚未得到充分研究，其预测因子的报道也很少。本研究的目的是调查抗抑郁药引起的神经过敏/焦虑综合征的发生率，并在自然的临床环境中阐明其预测因素。在2009年1月至2012年7月期间，我们前瞻性地调查了301名患者，这些患者在就诊前1个月内没有服用任何抗抑郁药，并且在首次就诊后1个月内服用抗抑郁药。如果患者在第一个月内出现任何焦虑、激越、惊恐发作、失眠、易怒、敌意、攻击性、冲动、静坐不能、轻躁狂或躁狂症状，则将其归类为发生抗抑郁药诱导的神经过敏/焦虑综合征。在301例患者中，21例（7.0%）发生抗抑郁药诱导的神经过敏/焦虑综合征。重度抑郁症和患者一级亲属中的心境障碍诊断与抗抑郁药诱导的神经过敏/焦虑综合征的诱导显著相关（比值比10.2，P=0.001;比值比4.65，P=0.02;分别）。然而，与性别、年龄、抗抑郁药类别、苯二氮卓类药物联合使用或焦虑症诊断无关。这项研究的结果表明，重度抑郁症和一级亲属的心境障碍的诊断可能是抗抑郁药引起的神经过敏/焦虑综合征的临床预测因子。
Patients often develop neuropsychiatric symptoms such as anxiety and agitation after they have started taking an antidepressant, and this is thought to be associated with a potentially increased risk of suicide. However, the incidence of antidepressant-induced jitteriness/anxiety syndrome has not been fully investigated, and little has been reported on its predictors. The aim of this study was to survey the incidence of antidepressant-induced jitteriness/anxiety syndrome and clarify its predictors in a natural clinical setting. Between January 2009 and July 2012, we prospectively surveyed 301 patients who had not taken any antidepressants for 1 month before presentation, and who were prescribed antidepressants for 1 month after their initial visit. Patients were classified as developing antidepressant-induced jitteriness/anxiety syndrome if they experienced any symptoms of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, or mania during the first month. Among the 301 patients, 21 (7.0%) developed antidepressant-induced jitteriness/anxiety syndrome. Major depressive disorder and a diagnosis of mood disorder in first-degree relatives of patients were significantly associated with induction of antidepressant-induced jitteriness/anxiety syndrome (odds ratio 10.2, P=0.001; odds ratio 4.65, P=0.02; respectively). However, there was no such relationship for sex, age, class of antidepressant, combined use of benzodiazepines, or diagnosis of anxiety disorder. The findings of this study suggest that major depressive disorder and a diagnosis of mood disorder in first-degree relatives may be clinical predictors of antidepressant-induced jitteriness/anxiety syndrome.