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首页> 外文期刊>The journal of clinical psychiatry >Switching patients from daily citalopram, paroxetine, or sertraline to once-weekly fluoxetine in the maintenance of response for depression.
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Switching patients from daily citalopram, paroxetine, or sertraline to once-weekly fluoxetine in the maintenance of response for depression.

机译：将患者从每日西酞普兰，帕罗西汀或舍曲林改为每周一次氟西汀，以维持抑郁症的反应。

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BACKGROUND: Major depressive disorder is frequently a chronic, recurrent condition necessitating maintenance treatment. For some patients, compliance with daily pharmacotherapy is difficult over time. As an alternative approach, a once-weekly administered formulation of fluoxetine has recently been made available. This raises the important question of whether once-weekly enteric-coated fluoxetine, 90 mg, is effective for maintenance of response in patients whose depressive symptoms have responded to daily dosing with selective serotonin reuptake inhibitors (SSRIs) such as citalopram, paroxetine, or sertraline. METHOD: Patients had met DSM-IV criteria for major depressive disorder prior to beginning treatment for their current episode, had received 6 to 52 weeks of treatment with citalopram (20-40 mg/day [N = 83]), paroxetine (20 mg/day [N = 77]), or sertraline (50-100 mg/day [N = 86]), and had responded to that treatment (Clinical Global Impressions-Severity of Illness [CGI-S] score < or = 2, modified 17-item Hamilton Rating Scale for Depression [HAM-D-17] score < or = 10). Patients meeting these criteria (N = 246) continued treatment with their current SSRI for 1 week, then were switched to open-label enteric-coated fluoxetine, 90 mg, taken once weekly for 12 weeks. Safety measures were comparisons of spontaneously reported and solicited treatment-emergent adverse events. Efficacy measures were percentages of patients who discontinued the study for relapse and lack of efficacy and comparison of change from baseline to endpoint in scores on the modified HAM-D-17, subscales of the HAM-D-28, and the CGI-S. Quality of life measures were assessed with the MOS 36-Item Short-Form Health Survey (SF-36). We hypothesized that the once-weekly administration of fluoxetine could be safely and effectively initiated among subjects who had been stabilized on daily SSRI treatment. RESULTS: Seventy-nine percent of patients successfully completed a switch to enteric-coated fluoxetine, 90 mg, with 9.3% discontinuing due to relapse or lack of efficacy. Enteric-coated fluoxetine at a once-weekly dose of 90 mg was well tolerated in all groups. No significant increases were found in the HAM-D-17 total, HAM-D-28 subscores, or CGI-S score. Patients showed improvement from baseline to endpoint in most of the SF-36 health concepts. CONCLUSION: Enteric-coated fluoxetine taken once weekly appears to be well tolerated and efficacious in patients who responded to acute therapy with other SSRIs and were subsequently switched to fluoxetine once weekly for continuation/maintenance therapy.
机译：背景：重度抑郁症通常是一种慢性复发性疾病，需要维持治疗。对于某些患者，随着时间的流逝，难以每天遵从药物治疗。作为一种替代方法，最近已经提供了氟西汀每周一次给药的制剂。这就提出了一个重要的问题，即每周一次的肠溶衣氟西汀（90毫克）对于抑郁症状已对选择性5-羟色胺再摄取抑制剂（SSRIs）（例如西酞普兰，帕罗西汀或舍曲林）的每日剂量有反应的患者，是否能有效维持反应。方法：患者在开始治疗当前抑郁发作之前已达到重度抑郁症的DSM-IV标准，接受西酞普兰（20-40 mg /天[N = 83]），帕罗西汀（20 mg /天）治疗6至52周/天[N = 77]）或舍曲林（50-100毫克/天[N = 86]），并且对该治疗有反应（临床总体印象-疾病严重程度[CGI-S]得分<或= 2，修改的17项汉密尔顿抑郁抑郁量表[HAM-D-17]得分<或= 10）。符合这些标准的患者（N = 246）继续用当前的SSRI治疗1周，然后改用90 mg开标签的肠溶氟西汀，每周一次，持续12周。安全措施是对自发报告的和引起治疗的不良事件进行比较。疗效指标是因修改后的HAM-D-17，HAM-D-28子量表和CGI-S评分中因复发和缺乏疗效而中止研究的患者百分比，以及从基线到终点的变化比较。生活质量衡量标准通过MOS 36项简短健康调查（SF-36）进行评估。我们假设在每日SSRI治疗稳定的受试者中，可以安全有效地开始每周一次的氟西汀治疗。结果：79％的患者成功完成了90毫克肠溶衣氟西汀的转换，其中9.3％的患者因复发或缺乏疗效而停药。在所有组中，肠溶性氟西汀的每周一次剂量为90 mg，耐受性良好。 HAM-D-17总数，HAM-D-28子分数或CGI-S得分未发现显着增加。在大多数SF-36健康概念中，患者表现出从基线到终点的改善。结论：对于其他SSRI的急性治疗有反应的患者，每周服用一次肠溶性氟西汀似乎耐受性好且有效，随后每周更换一次氟西汀以进行持续/维持治疗。

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