Paroxetine for the prevention of depression induced by high-dose interferon alfa
Paroxetine for the prevention of depression induced by high-dose interferon alfa
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DOI：
10.1056/nejm200103293441303
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发表时间：
2001-03-29
影响因子：
158.5
通讯作者：
Miller, AH
中科院分区：
文献类型：
--
作者：
Musselman, DL;Lawson, DH;Miller, AH
背景：抑郁通常会使细胞因子干扰素ALFA-2B的治疗复杂化。用抗抑郁药预处理的实验动物在给药细胞因子后的严重抑郁症状症状较低。我们试图确定类似策略是否对人类有效。方法：在对40例恶性黑色素瘤患者的双盲研究中，他们有资格接受高剂量干扰素alfa疗法，我们随机分配20例患者接受抗抑郁药paroxetine和20例接受安慰剂。 The treatment was begun 2 weeks before the initiation of interferon alfa and continued for the first 12 weeks of interferon alfa therapy.Results: During the first 12 weeks of interferon alfa therapy, symptoms consistent with a diagnosis of major depression developed in 2 of 18 patients in the paroxetine group (11 percent) and 9 of 20 patients in the placebo group (45 percent) (relative risk, 0.24; 95 percent confidence interval, 0.08 to 0.93）。严重的抑郁症需要在帕罗西汀组的20例患者中有12周之前停用干扰素alfa（5％），而安慰剂组的7例患者（相对风险为0.14； 95％置信区间，0.05至0.85）。两组中不良事件的发生率相似。结论：在恶性黑色素瘤的患者中，对帕罗西汀进行预处理似乎是最大程度地减少Interferon alfa诱导的抑郁症的有效策略。 （N Engl J Med 2001; 344：961-6。）版权（c）2001马萨诸塞州医学会。
Background: Depression commonly complicates treatment with the cytokine interferon alfa-2b. Laboratory animals pretreated with antidepressants have less severe depression-like symptoms after the administration of a cytokine. We sought to determine whether a similar strategy would be effective in humans.Methods: In a double-blind study of 40 patients with malignant melanoma who were eligible for high-dose interferon alfa therapy, we randomly assigned 20 patients to receive the antidepressant paroxetine and 20 to receive placebo. The treatment was begun 2 weeks before the initiation of interferon alfa and continued for the first 12 weeks of interferon alfa therapy.Results: During the first 12 weeks of interferon alfa therapy, symptoms consistent with a diagnosis of major depression developed in 2 of 18 patients in the paroxetine group (11 percent) and 9 of 20 patients in the placebo group (45 percent) (relative risk, 0.24; 95 percent confidence interval, 0.08 to 0.93). Severe depression necessitated the discontinuation of interferon alfa before 12 weeks in 1 of the 20 patients in the paroxetine group (5 percent), as compared with 7 patients in the placebo group (35 percent) (relative risk, 0.14; 95 percent confidence interval, 0.05 to 0.85). The incidence of adverse events was similar in the two groups.Conclusions: In patients with malignant melanoma, pretreatment with paroxetine appears to be an effective strategy for minimizing depression induced by interferon alfa. (N Engl J Med 2001;344:961-6.) Copyright (C) 2001 Massachusetts Medical Society.