Fluoxetine for depression in diabetes - A randomized double-blind placebo-controlled trial
Fluoxetine for depression in diabetes - A randomized double-blind placebo-controlled trial
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DOI：
10.2337/diacare.23.5.618
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发表时间：
2000-05-01
期刊：
影响因子：
16.2
通讯作者：
Clouse, RE
中科院分区：
文献类型：
--
作者：
Lustman, PJ;Freedland, KE;Clouse, RE
目的-抑郁症在糖尿病患者中普遍存在。它与血糖控制不良有关，并与糖尿病并发症的风险增加有关。在这项研究中，我们评估了氟西汀对糖尿病患者抑郁症的疗效。研究设计和方法-60例糖尿病患者（1型，n = 26; 2型，n = 34）和重度抑郁症进入一个为期8周的随机安慰剂对照双盲试验。患者接受每日剂量的氟西汀（高达40 mg/天）。采用Beck抑郁量表（BDI）和汉密尔顿抑郁量表（HAMD）评定抑郁的严重程度，并确定获得显著改善或完全缓解的患者百分比。结果-氟西汀治疗组抑郁症状的减轻程度明显大于安慰剂组（BDI，- 14.0 vs. -8.8，P = 0.03; HAMD，-10.7 vs. -5.2，P = 0.01）。根据BDI，氟西汀组抑郁症显著改善的患者百分比也较高（66.7% vs. 37.0%，P = 0.03）。此外，在氟西汀组中观察到抑郁症缓解率更高（48.1%对25.9%，P = 0.09，根据HAMD）和GHb降低幅度更大（-0.40%对-0.07%，P = 0.13）的趋势。我们的研究表明，仅仅8周后，这种治疗也产生了更好的血糖控制趋势。
OBJECTIVE - Depression is prevalent in patients with diabetes. It is associated with poor glycemic control and is linked to an increased risk for diabetic complications. In this study, we assessed the efficacy of fluoxetine for depression in patients with diabetes.RESEARCH DESIGN AND METHODS- Sixty patients with diabetes (type 1, n = 26; type 2, n = 34) and major depressive disorder entered an 8-week randomized placebo-controlled double-blind trial. Patients were given daily doses of fluoxetine (up to 40 mg/day). The Beck Depression Inventory (BDI) and Hamilton Rating Scale for Depression (HAMD) were used to measure the severity of depression and to determine the percentage of patients who achieved substantial improvement or complete remission. GHb levels were obtained to monitor glycemic control.RESULTS - Reduction in depression symptoms was significantly greater in patients treated with fluoxetine compared with those receiving placebo (BDI, - 14.0 vs. -8.8, P = 0.03; HAMD, -10.7 vs. -5.2, P = 0.01). The percentage of patients achieving a significant improvement in depression per the BDI was also higher in the fluoxetine group (66.7 vs. 37.0%, P = 0.03). Additionally, trends toward a greater rate of depression remission (48.1 vs. 25.9%, P = 0.09 per the HAMD) and greater reduction in GHb (-0.40 vs. -0.07%, P = 0.13) were observed in the flu oxetine group.CONCLUSIONS- Fluoxetine effectively reduces the severity of depression in diabetic patients. Our study demonstrated that after only 8 weeks, this treatment also produced a trend toward better glycemic control.