Assessing the effects of bupropion SR on mood dimensions of depression.
Assessing the effects of bupropion SR on mood dimensions of depression.
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DOI：
10.1016/s0165-0327(02)00306-3
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发表时间：
2004-03
影响因子：
6.6
通讯作者：
A. Tomarken;G. Dichter;C. Freid;S. Addington;R. Shelton
中科院分区：
文献类型：
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作者：
A. Tomarken;G. Dichter;C. Freid;S. Addington;R. Shelton
本研究通过情绪三方模型评估安非他酮SR和安慰剂对情绪和焦虑症状的治疗效果。基于多巴胺能活性与积极情绪/快感缺乏症的情感维度之间存在联系的证据，我们假设安非他酮SR的多巴胺能效应会对快感缺乏症症状产生特别显著的影响，相对于焦虑而言。方法将19例抑郁症门诊患者随机分为安非他酮SR 300 mg/d组和安慰剂组，初始治疗期6周。随后是第二个开放标签阶段，先前用安非他酮SR治疗的患者剂量增加到400毫克/天，安慰剂组开始使用安非他酮SR 300毫克/天。结果随机回归分析显示，在最初的双盲阶段，除了焦虑评估外，安非他酮SR在所有指标上都比安慰剂有更大的下降。相比之下，安慰剂对快感缺乏症的影响最弱。快感缺失维度的低正向情感极对早期/低剂量安非他酮SR治疗更敏感，而高正向情感极对后期/高剂量安非他酮SR治疗更敏感。限制：必须使用更大的样本量进行复制和扩展。结论安非他酮SR的儿茶酚胺能作用比安慰剂对快感缺乏症/积极影响的作用更强。
BackgroundWe assessed the therapeutic effects of bupropion SR and placebo on mood and anxiety symptoms derived from the tripartite model of mood. Based on evidence indicating linkages between dopaminergic activity and the emotional dimension of positive affect/anhedonia, we hypothesized that the dopaminergic effects of bupropion SR would yield particularly pronounced effects on symptoms of anhedonia, relative to anxiety.MethodsNineteen depressed outpatients were randomly assigned to treatment with either bupropion SR 300 mg/day or placebo during a 6-week initial treatment phase. This was followed by a second open-label phase in which patients previously treated with bupropion SR had their dose increased to 400 mg/day, and the placebo group was initiated on bupropion SR 300 mg/day.ResultsRandom regression analyses revealed that during the initial double-blind phase, bupropion SR elicited greater declines than placebo on all measures except those that assessed anxiety. By contrast, the weakest placebo effects were evident on anhedonia. Items assessing the low positive affect pole of the anhedonia dimension were more sensitive to earlier/lower dose bupropion SR treatment, whereas items assessing the high positive affect pole were more sensitive to later/higher dose bupropion SR treatment.LimitationsReplication and extension using a larger sample size are mandated.ConclusionsThis study suggests that the catecholaminergic effects of bupropion SR tended to produce more robust effects on anhedonia/positive affect than placebo.