Self-reported obstructive sleep apnea is associated with nonresponse to antidepressant pharmacotherapy in late-life depression.
Self-reported obstructive sleep apnea is associated with nonresponse to antidepressant pharmacotherapy in late-life depression.
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DOI：
10.1002/da.22555
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发表时间：
2016-12
影响因子：
7.4
通讯作者：
Karp, Jordan F.
中科院分区：
文献类型：
--
作者：
Waterman, Lauren;Stahl, Sarah T.;Buysse, Daniel J.;Lenze, Eric J.;Blumberger, Daniel;Mulsant, Benoit;Butters, Meryl;Gebara, Marie Anne;Reynolds, Charles F., III;Karp, Jordan F.
阻塞性睡眠呼吸暂停（OSA）经常与晚年抑郁症共病。本项目的目的是确定，使用一个样本的老年抑郁症，患者报告的诊断OSA是否与文拉法辛的反应率。这项多中心研究的受试者为≥60岁的重度抑郁障碍成人（n = 468），蒙哥马利阿斯伯格抑郁量表（MADRS）评分≥15。抑郁反应是结局变量，定义为文拉法辛300 mg/d开放标签治疗12周结束时两次连续评估的MADRS评分≤10。为了评估OSA，参与者被问及他们是否被诊断患有OSA使用多导睡眠图。80名参与者（17.1%）在基线前报告了OSA的诊断。患有OSA的参与者更可能是男性，报告健康指标受损更大，指数发作持续时间更长，并且在进入研究之前接受了充分的抗抑郁药试验。在12周的治疗期间，40.8%的患者对文拉法辛治疗有反应（43.6%，n = 169/388的无OSA组和27.5%，n = 22/80的OSA组）。与OSA患者相比，无OSA患者对治疗有反应的可能性高1.79倍（HR：1.79 [95%CI：1.13-2.86]，P <0.05）。阻塞性睡眠呼吸暂停综合征可能损害老年抑郁症患者抗抑郁药物治疗的反应。未来对患有OSA的抑郁老年人的抗抑郁反应率的研究应该前瞻性地诊断OSA并监测持续气道正压通气等治疗的依从性。
Obstructive sleep apnea (OSA) is frequently comorbid with late-life depression. The purpose of this project was to determine, using a sample of older adults with major depressive disorder, whether patient-reported diagnosis of OSA was associated with rate of response to venlafaxine. Participants from this multisite study were adults ≥60 years old (n = 468) with major depressive disorder and a Montgomery Asberg Depression Rating Scale (MADRS) score of ≥15. Depression response was the outcome variable, defined as a MADRS score of ≤10 for two consecutive assessments at the end of 12 weeks of open-label treatment with venlafaxine 300 mg/day. To assess OSA, participants were asked if they had been diagnosed with OSA using polysomnography. Eighty participants (17.1%) reported a diagnosis of OSA prior to baseline. Participants with OSA were more likely to be male, report greater impairment on measures of health, experience a longer duration of the index episode, and receive an adequate antidepressant trial prior to entering the study. During the 12 weeks of treatment, 40.8% responded to treatment with venlafaxine (43.6%, n = 169/388 of the no OSA group, and 27.5%, n = 22/80 of the OSA group). Participants without OSA were 1.79 times more likely to respond to treatment (HR: 1.79 [95%CI: 1.13–2.86], P < .05) compared to those with OSA. OSA may impair response to antidepressant pharmacotherapy in depressed older adults. Future studies of antidepressant response rates among depressed older adults with OSA should both prospectively diagnose OSA and monitor adherence to treatments such as continuous positive airway pressure.
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影响因子：
9.6
作者：
Lal, Chitra;Strange, Charlie;Bachman, David
通讯作者：
Bachman, David
DOI：
10.1016/s0140-6736(15)00308-6
发表时间：
2015-12-12
期刊：
Lancet (London, England)
影响因子：
--
作者：
Lenze EJ;Mulsant BH;Blumberger DM;Karp JF;Newcomer JW;Anderson SJ;Dew MA;Butters MA;Stack JA;Begley AE;Reynolds CF 3rd
通讯作者：
Reynolds CF 3rd
影响因子：
4.7
作者：
Ong, Jason C.;Gress, Jenna L.;Manber, Rachel
通讯作者：
Manber, Rachel
影响因子：
4.8
作者：
Manber, R;Blasey, C;Keller, MB
通讯作者：
Keller, MB
影响因子：
5.9
作者：
BECK, AT;KOVACS, M;WEISSMAN, A
通讯作者：
WEISSMAN, A