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首页> 外文期刊>The journal of clinical psychiatry >Lamotrigine as adjunct to paroxetine in acute depression: a placebo-controlled, double-blind study.
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Lamotrigine as adjunct to paroxetine in acute depression: a placebo-controlled, double-blind study.

机译：拉莫三嗪在急性抑郁症中可作为帕罗西汀的辅助药物：一项安慰剂对照的双盲研究。

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BACKGROUND: Mood stabilizers appear to be more potent in treating mania than depression. The anticonvulsant lamotrigine has been shown to be effective for bipolar depression. This study examines putative antidepressive properties of lamotrigine in a mainly unipolar routine clinical patient population. METHOD: Forty patients with a depressive episode (DSM-IV criteria) requiring psychiatric intervention received lamotrigine or placebo using a fixed dose escalation scheme with a target dose of 200 mg/day for 9 weeks. Additionally, all patients were treated with paroxetine. Hamilton Rating Scale for Depression (HAM-D) and Clinical Global Impressions scale (CGI) ratings were used to monitor therapeutic efficacy. RESULTS: Adjunctive treatment with lamotrigine did not result in a significant difference in HAM-D total score at the endpoint of the study when compared with paroxetine alone. However, lamotrigine demonstrated significant efficacy on core depressive symptoms as reflected by HAM-D items 1 (depressed mood; p = .0019), 2 (guilt feelings; p = .0011), and 7 (work and interest; p = .049) and the CGI-Severity of Illness scale (p < .0001). Patients receiving lamotrigine had fewer days on treatment with benzodiazepines and fewer withdrawals for treatment failure. Lamotrigine appeared to accelerate the onset of action of the antidepressant. Two patients on lamotrigine treatment developed neutropenia, and 1 developed a benign rash. There was no detectable pharmacokinetic interaction between lamotrigine and paroxetine. CONCLUSION: Lamotrigine might have antidepressive properties in unipolar patients and may accelerate onset of action when given in combination with typical antidepressants.
机译：背景：情绪稳定剂似乎在治疗躁狂方面比抑郁症更有效。抗惊厥药拉莫三嗪已被证明对双相抑郁症有效。这项研究检查了拉莫三嗪在主要单极常规临床患者人群中的推定抗抑郁特性。方法：40名需要精神科干预的抑郁发作（DSM-IV标准）的患者采用固定剂量递增方案接受拉莫三嗪或安慰剂，目标剂量为200 mg /天，持续9周。此外，所有患者均接受帕罗西汀治疗。使用汉密尔顿抑郁量表（HAM-D）和临床总体印象量表（CGI）来监测治疗效果。结果：与单独的帕罗西汀相比，拉莫三嗪的辅助治疗在研究终点时未导致HAM-D总评分有显着差异。然而，拉莫三嗪对核心抑郁症状表现出显着疗效，如HAM-D第1项（情绪低落; p = 0.0019），2（内gui感; p = 0.001）和7（工作和兴趣; p = 0.049）所反映。 ）和CGI-疾病严重程度等级（p <.0001）。接受拉莫三嗪治疗的患者接受苯二氮卓类药物治疗的天数更少，并且因治疗失败而停药的次数也更少。拉莫三嗪似乎可以加快抗抑郁药的作用。接受拉莫三嗪治疗的2例患者出现中性粒细胞减少症，其中1例出现了良性皮疹。拉莫三嗪和帕罗西汀之间没有可检测到的药代动力学相互作用。结论：拉莫三嗪在单相患者中可能具有抗抑郁作用，与典型的抗抑郁药合用时，可能会加速其起效。

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