A prospective trial of sertraline for chronic subjective dizziness
A prospective trial of sertraline for chronic subjective dizziness
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DOI：
10.1097/00005537-200409000-00025
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发表时间：
2004-09-01
期刊：
影响因子：
2.6
通讯作者：
Amsterdam, JD
中科院分区：
文献类型：
--
作者：
Staab, JP;Ruckenstein, MJ;Amsterdam, JD
目的/假设：作者先前报道，选择性5-羟色胺再摄取抑制剂(SSRI)可以减少有和没有精神疾病患者的慢性主观头晕。为了扩展这些初步发现，并检验SSRIs可能为慢性主观头晕提供一种新疗法的假设，作者在没有活动的身体神经疾病的情况下，对头晕患者进行了一项前瞻性研究，持续时间超过6个月。研究设计。为期16周的前瞻性、开放标签、灵活剂量的临床试验。方法：对24例主观性眩晕持续6个月以上、无活动性躯体神经病的患者进行研究。18名患者患有严重的焦虑症。其中六人有轻微的挫折感或担忧，不足以做出精神诊断。舍曲林每日剂量为25毫克，增加到每日最大剂量200毫克。采用头晕、功能障碍和心理困扰量表(DHI)和简明症状自评量表(BSI-53)进行评定。使用重复测量多变量方差分析来分析治疗结果，并延续最后的观察结果。结果：3名患者因丧失医疗条件资格而被排除在数据分析之外，1名患者因违反协议而被排除。15名患者(75%)完成了治疗。5例(25%)因不良反应或无效而停用。舍曲林的日平均剂量为100毫克。舍曲林显著降低了所有三个DHI分量表和BSI-53的分数。完成治疗的15名患者中有11名(73%)有阳性反应，其中11名患者中有8名(73%)患有严重焦虑症，4名患者中有3名(75%)没有精神疾病。6名患者的症状完全缓解。结论：舍曲林显著减少了没有活动的躯体神经疾病的患者的慢性主观头晕，包括那些有和没有精神疾病共病的患者。
Objectives/Hypothesis: The authors previously reported that selective serotonin reuptake inhibitors (SSRIs) reduce chronic subjective dizziness in patients with and without psychiatric illnesses. To extend those preliminary findings and test the hypothesis that SSRIs may offer a novel treatment for chronic subjective dizziness, the authors conducted a prospective study of sertraline in patients with dizziness for more than 6 months, in the absence of active physical neurotologic illness. Study Design. Sixteen-week, prospective, open-label, flexible-dose clinical trial. Methods: Twenty-four patients with subjective dizziness for more than 6 months and no active physical neurotologic illness were studied. Eighteen patients had major anxiety disorders. Six had minor frustration or worry that did not warrant a psychiatric diagnosis. Sertraline was administered at a daily dose of 25 mg, which was increased to a maximum daily dose of 200 mg. Dizziness, functional impairment, and psychological distress were measured using the Dizziness Handicap Inventory (DHI) and Brief Symptom Inventory-53 (BSI-53). Treatment outcomes were analyzed using repeated-measures multivariate analyses of variance, with last observations carried forward. Results: Three patients were excluded from data analysis for disqualifying medical conditions, one for protocol violations. Fifteen (75%) patients completed treatment. Five (25%) withdrew for adverse effects or lack of efficacy. The median daily dose of sertraline was 100 mg. Sertraline significantly reduced scores on all three DHI subscales and the BSI-53. Eleven of 15 (73%) patients who completed treatment had a positive response, including 8 of 11 (73%) with major anxiety disorders and 3 of 4 (75%) with no psychopathological conditions. Six patients enjoyed a full remission of symptoms. Conclusion: Sertraline significantly reduced chronic subjective dizziness in patients without active physical neurotologic illness, including those with and without psychiatric comorbidity.