Zinc supplementation augments efficacy of imipramine in treatment resistant patients: A double blind, placebo-controlled study
Zinc supplementation augments efficacy of imipramine in treatment resistant patients: A double blind, placebo-controlled study
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DOI：
10.1016/j.jad.2009.02.014
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发表时间：
2009-11-01
影响因子：
6.6
通讯作者：
Nowak, Gabriel
中科院分区：
文献类型：
--
作者：
Siwek, Marcin;Dudek, Dominika;Nowak, Gabriel
背景资料：抑郁症治疗中的主要问题之一是抗抑郁药的疗效有限和增强策略的效用有限。锌是一种非竞争性NMDA受体拮抗剂，具有临床前抗抑郁作用。此外，初步的临床报告表明增强抗抑郁治疗锌在depression.Methods：安慰剂对照，双盲研究丙咪嗪治疗中补锌进行了60，18-55岁，单相抑郁症患者符合DSM-IV标准的抑郁症没有精神病症状。在一周的洗脱期后，患者被随机分为两组，分别接受丙咪嗪（类似于140 mg/天）治疗和安慰剂（n = 30）或锌补充剂（n = 30）每日一次治疗。结果：补锌组和安慰剂组抗抑郁治疗无抵抗患者的CGI、BDI、HADRS和MADRS评分无显著性差异。然而，补锌显着降低抑郁症评分和促进抗抑郁药治疗耐药patients.Conclusion：补锌增强的疗效和速度的治疗反应，以丙咪嗪治疗的发病，特别是在以前无反应的抗抑郁药物治疗的患者。这些数据表明，参与干扰锌/amatergic传输的耐药性的病理生理学。(C)2009爱思唯尔有限公司版权所有。
Background: One of the main problems in the therapy of depression is the limited efficacy of antidepressants and the limited utility of augmentation strategies. Zinc, a non competitive NMDA receptor antagonist exhibits preclinical antidepressant efficacy. Moreover, a preliminary clinical report suggests augmentation of antidepressant therapy by zinc in depression.Methods: A placebo-controlled, double blind study of zinc supplementation in imipramine therapy was conducted in sixty, 18-55-year old, unipolar depressed patients fulfilling the DSM-IV criteria for major depression without psychotic symptoms. After a one week washout period, patients were randomized into two groups treated with imipramine (similar to 140 mg/day) and receiving once daily either placebo (n = 30) or zinc supplementation (n = 30. 25 mgZn/day) for 12 weeks.Results: No significant differences in CGI, BDI, HADRS and MADRS scores were demonstrated between zinc-supplemented and placebo-supplemented antidepressant treatment nonresistant patients. However, zinc supplementation significantly reduced depression scores and facilitated the treatment outcome in antidepressant treatment resistant patients.Conclusion: Zinc supplementation augments the efficacy and speed of onset of therapeutic response to imipramine treatment, particularly in patients previously nonresponsive to antidepressant pharmacotherapies. These data suggest the participation of disturbed zinc/glutamatergic transmission in the pathophysiology of drug resistance. (C) 2009 Elsevier B.V. All rights reserved.