Fluvoxamine treatment of mixed anxiety and depression: evidence for serotonergically mediated anxiolysis.
Fluvoxamine treatment of mixed anxiety and depression: evidence for serotonergically mediated anxiolysis.
复制标题
氟伏沙明治疗混合焦虑和抑郁：血清素介导的抗焦虑作用的证据。
DOI：
10.1097/00004714-200104000-00004
复制
发表时间：
2001
影响因子：
2.9
通讯作者：
Li,J
中科院分区：
文献类型：
--
作者：
Rausch,JL;Hobby,HM;Shendarkar,N;Johnson,ME;Li,J
虽然越来越多的证据表明，选择性5-羟色胺再摄取抑制剂（SSRI）治疗可能是有效的焦虑除了抑郁症，SSRI抗焦虑尚未明确相关的5-羟色胺（5-HT）转运的抑制。编码人类5-羟色胺转运蛋白（5-HTT）的基因在神经元和血小板中表达其蛋白质，两种组织对SSRI治疗的转运抑制反应相似。本研究在一组18例氟伏沙明治疗的患者中检测了5-HTT对5-HT的表观亲和力的变化与抗焦虑反应之间的关系，该组患者符合DSM-IV广泛性焦虑障碍和重度抑郁症的结构化临床访谈标准。在2个月的治疗期间，发现汉密尔顿焦虑和汉密尔顿抑郁评分均显著降低。血小板转运5-HT的表观亲和力常数（Km）随治疗而显著增加，且与焦虑程度的降低呈显著协变（F= 4.97，p< 0.03）。治疗前5-HTT Km与抑郁评分的改善显著相关（r= 0.53，p< 0.03），符合初始条件假设。这些结果表明，SSRI治疗的治疗效果可以与氟伏沙明，一种似乎具有与其对抑郁症的作用相同的抗焦虑作用的药物的5-HT转运抑制的幅度和时间过程相关联。
Although increasing evidence suggests that selective serotonin reuptake inhibitor (SSRI) treatment may be effective for anxiety in addition to depression, SSRI anxiolysis has not been definitively related to the inhibition of serotonin (5-HT) transport. The gene that encodes for the human serotonin transporter (5-HTT) expresses its protein in neurons and in blood platelets, and both tissues respond to transport inhibition similarly in response to SSRI treatment. This study examined the relationship between the change in the 5-HTT's apparent affinity for 5-HT and the anxiolytic response in a group of 18 fluvoxamine-treated patients meeting Structured Clinical Interview for DSM-IV criteria for both generalized anxiety disorder and major depression. Significant decreases were found in both Hamilton anxiety and Hamilton depression scores over a 2-month treatment period. Robust increases were found in the apparent affinity constant (K m) for platelet 5-HT transport with treatment, and the increases covaried significantly with the decrease in anxiety (F= 4.97, p< 0.03). The pretreatment 5-HTT K m significantly correlated with the improvement in depression scores (r= 0.53, p< 0.03), consistent with the Hypothesis of Initial Conditions. These results suggest that the therapeutic effect of SSRI treatment can be linked to the magnitude and time-course of 5-HT transport inhibition effected with fluvoxamine, a drug that seems to have an antianxiety effect of the same magnitude as its effect on depression.