Comparison of the effects of escitalopram and nortriptyline on painful symptoms in patients with major depression
Comparison of the effects of escitalopram and nortriptyline on painful symptoms in patients with major depression
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DOI：
10.1016/j.genhosppsych.2014.10.005
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发表时间：
2015-01-01
影响因子：
7
通讯作者：
Hauser, Joanna
中科院分区：
文献类型：
--
作者：
Jaracz, Jan;Gattner, Karolina;Hauser, Joanna
目的：抑郁症患者经常报告无法解释的疼痛性身体症状。有证据表明，双效抗抑郁药可以有效缓解抑郁症的疼痛。然而，迄今为止尚未研究选择性5-羟色胺能抗抑郁药和选择性去甲肾上腺素能抗抑郁药对疼痛症状的影响的直接比较。 方法：参与基于基因组的抑郁症治疗药物研究的60名患者，根据国际疾病分类第10版和精神障碍诊断与统计手册第四版标准诊断为中度或重度抑郁症发作。所有参与者被随机分配接受去甲替林或艾司西酞普兰治疗。在第 0、2、4、6 和 8 周使用蒙哥马利-阿斯伯格抑郁量表、汉密尔顿抑郁量表和贝克抑郁量表测量抑郁的严重程度。在研究的相同时间点使用视觉模拟量表测量疼痛强度。结果：在“第 0 周”，83.3% 的患者后来随机接受艾司西酞普兰治疗，86.7% 的患者接受艾司西酞普兰治疗。去甲替林报告了至少一种疼痛症状。治疗两周后观察到疼痛强度显着降低。与基线值相比，两组在第 2、4、6 和 8 周的疼痛减轻程度没有差异。疼痛强度降低 50% 先于抑郁严重程度降低 50%。在第 8 周缓解或未缓解的患者中，“第 0 周”时的疼痛强度没有差异。结论：选择性血清素能抗抑郁药和选择性去甲肾上腺素能抗抑郁药在缓解抑郁症的疼痛身体症状方面同样有效。治疗开始前疼痛症状的存在并不能决定最终的反应。 (C) 2015 Elsevier Inc. 保留所有权利。
Objective: Unexplained painful physical symptoms are commonly reported by depressed patients. The evidence suggests that dual-action antidepressants are potent in relieving pain in depression. However, a direct comparison of the effects of selective serotonergic and selective noradrenergic antidepressants on painful symptoms has not been investigated so far.Method: Sixty patients who participated in the Genome-based Therapeutic Drugs for Depression study with a diagnosis of moderate or severe episodes of depression according to the International Classification of Diseases, 10th Revision, and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were involved. All the participants were randomly allocated to receive nortriptyline or escitalopram. The severity of depression was measured using the Montgomery-Asberg Depression Rating Scale, the Hamilton Depression Rating Scale and the Beck Depression Inventory at weeks 0, 2, 4, 6 and 8. The intensity of pain was measured on the Visual Analog Scale at the same points of the study.Results: At "week 0," 83.3% of the patients later randomized to treatment with escitalopram and 86.7% of those treated with nortriptyline reported at least one painful symptom. A significant decrease of pain intensity was observed after 2 weeks of treatment. The two groups did not differ in degree of pain reduction at weeks 2, 4, 6 and 8 in comparison to baseline values. A 50% reduction in pain intensity preceded the 50% reduction of depression severity. The intensity of pain at " week 0" did not differ in remitted or nonremitted patients at week 8.Conclusion: Both selective serotonergic and selective noradrenergic antidepressants are equally effective in alleviations of painful physical symptoms of depression. The presence of painful symptoms before the onset of treatment did not determine the final response. (C) 2015 Elsevier Inc. All rights reserved.