Antidepressant Augmentation of Late Life Schizophrenia

抗抑郁药可增强晚年精神分裂症的疗效

• 批准号: 7382983
• 负责人: JOHN W. KASCKOW
• 金额: $ 2.32万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7382983
• 关键词: age difference; antidepressants; antipsychotic agents; clinical depression; clinical trials; drug screening /evaluation; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; mental disorder chemotherapy; patient oriented research; risperidone; schizophrenia; serotonin inhibitor

Depressive symptoms in schizophrenia, while highly prevalent, often chronic, and disabling, remain relatively understudied. Antidepressants are commonly used in clinical practice to treat a variety of symptoms in patients with schizophrenia. Although some literature describes the treatment of syndromal depression in primarily young adults with schizophrenia, comparatively little research is available to guide the treatment of subsyndromal depressive symptoms in this population, especially in middle-aged and older adults with schizophrenia. Older people with schizophrenia differ from their younger counterparts in several important ways, such as having greater physical comorbidity, cognitive impairment, and a higher risk of side effects. This study will evaluate the efficacy and safety of antidepressant (citalopram) versus placebo augmentation of atypical antipsychotics to treat subsyndromal, residual depressive symptoms in middle-aged and older patients with schizophrenia. This collaborative, two-site (University of California, San Diego and University of Cincinnati), five-year study hypothesizes that citalopram augmentation of antipsychotic medication will be more effective than augmentation with placebo at reducing depressive symptoms and enhancing functioning and quality of life. We propose to enroll a total of 240 outpatients with schizophrenia, who are 55 years or older and have a Hamilton Depression Rating Scale 17-item score of ten or greater, into a randomized, double-blind, flexible-dose, placebo-controlled study. After stabilization for at least four weeks on an atypical antipsychotic agent (either risperidone or olanzapine), patients who have residual depressive symptoms (HAM-D score of ten or greater) will be randomized to one of the following interventions: atypical antipsychotic (risperidone or olanzapine) plus citalopram; or atypical antipsychotic (risperidone or olanzapine) plus placebo. The double-blind treatment period will be three months with a follow-up assessment three months later. Depressive symptoms and side effects will be assessed weekly for the first month, biweekly for the second month, and again at the end of the third month. In addition, we will evaluate cognitive, motor and daily functioning, quality of life, and medication adherence throughout the study. Unique to this proposal, we will use performance-based outcome measures to assess real-world functional capacities. By providing empirical evidence to guide treatment of depressive symptoms in patients with schizophrenia, the study could have significant public health implications for the reduction of disability and the enhancement of quality of life in this patient population.

精神分裂症中的抑郁症状，虽然非常普遍， 通常是慢性的和致残的，仍然相对地研究不足。抗抑郁 在临床实践中通常用于治疗各种症状， 精神分裂症患者虽然一些文献描述了治疗 在年轻的精神分裂症患者中， 相对较少的研究可用于指导治疗 亚综合征抑郁症状在这一人群中，特别是在中年 和老年精神分裂症患者。老年精神分裂症患者 从他们的年轻同行在几个重要的方面，如有 更大的身体合并症，认知障碍，和更高的风险， 方面的影响.本研究将评价抗抑郁药的有效性和安全性 （西酞普兰）与安慰剂相比，非典型抗精神病药的强化治疗 中老年抑郁症患者的亚综合征残留症状 精神分裂症这个合作的，两个网站（加州大学，旧金山分校 Diego和辛辛那提大学），为期五年的研究假设， 西酞普兰增加抗精神病药物将更有效， 安慰剂增强治疗减轻抑郁症状和增强 功能和生活质量。我们建议共招收240名 精神分裂症门诊患者，55岁或以上，有汉密尔顿 抑郁评定量表17项评分为10分或更高，随机分为， 双盲、灵活剂量、安慰剂对照研究。稳定后， 至少四周的非典型抗精神病药物（利培酮或 奥氮平），有残余抑郁症状的患者（HAM-D评分为10 或更高）将被随机分配至以下干预措施之一：非典型 抗精神病药（利培酮或奥氮平）加西酞普兰;或非典型 抗精神病药（利培酮或奥氮平）加安慰剂。双盲 治疗期为3个月，随访评估为3个月 后每周评估抑郁症状和副作用， 第一个月，第二个月每两周一次，第三个月结束时再次 月此外，我们将评估认知，运动和日常功能， 生活质量和整个研究期间的药物依从性。独特的这个 建议，我们将使用基于性能的结果措施，以评估现实世界 功能能力。通过提供经验证据来指导治疗 精神分裂症患者的抑郁症状，这项研究可能有 对减少残疾的重大公共卫生影响， 提高该患者人群的生活质量。

项目成果

Does age moderate the relationship between depressive symptoms and suicidal ideation in middle-aged and older patients with schizophrenia and subthreshold depression?

• DOI: 10.1016/j.jagp.2013.01.039
• 发表时间: 2014-05
• 期刊: AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
• 影响因子: 7.2
• 作者: Kasckow, John;Golshan, Shahrokh;Zisook, Sidney
• 通讯作者: Zisook, Sidney

Managing suicide risk in patients with schizophrenia.

• DOI: 10.2165/11586450-000000000-00000
• 发表时间: 2011-02
• 期刊: CNS drugs
• 影响因子: 6
• 作者: Kasckow J;Felmet K;Zisook S
• 通讯作者: Zisook S

Elderly patients with schizophrenia and depression: diagnosis and treatment.

• DOI: 10.3371/csrp.4.4.4
• 发表时间: 2011-01
• 期刊: Clinical schizophrenia & related psychoses
• 作者: Felmet K;Zisook S;Kasckow JW
• 通讯作者: Kasckow JW

Functioning in middle aged and older patients with schizophrenia and depressive symptoms: relationship to psychopathology.

• DOI: 10.1097/jgp.0b013e31816ff746
• 发表时间: 2008-08
• 期刊: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
• 作者: Kasckow J;Patterson T;Fellows I;Golshan S;Solorzano E;Mohamed S;Zisook S
• 通讯作者: Zisook S

Treatment of subsyndromal depressive symptoms in middle-aged and older adults with schizophrenia: effect on functioning.

中老年精神分裂症亚综合征抑郁症状的治疗：对功能的影响。

• DOI: 10.1002/gps.2318
• 发表时间: 2010
• 期刊: International journal of geriatric psychiatry
• 影响因子: 4
• 作者: Kasckow,John;Lanouette,Nicole;Patterson,Thomas;Fellows,Ian;Golshan,Shahrokh;Solorzano,Ellen;Zisook,Sidney
• 通讯作者: Zisook,Sidney