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首页> 外文期刊>The journal of clinical psychiatry >Postpartum Depression Recurrence Versus Discontinuation Syndrome: Observations From a Randomized Controlled Trial.
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Postpartum Depression Recurrence Versus Discontinuation Syndrome: Observations From a Randomized Controlled Trial.

机译：产后抑郁症复发与停药综合症：来自随机对照试验的观察结果。

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OBJECTIVE: To differentiate characteristics of a discontinuation syndrome from a recurrence of major depressive disorder in the context of a randomized trial. METHOD: We performed a randomized clinical trial to compare the efficacy of sertraline versus placebo for the prevention of recurrent postpartum DSM-IV major depressive disorder. Women whose depression did not recur in the initial 17-week active treatment trial were followed through the taper phase (weeks 18-20). At week 17, 3 women assigned to placebo and 8 assigned to sertraline remained in the trial. Nine symptoms that characterize discontinuation syndrome were extracted from the 25-item Asberg Rating Scale for Side Effects (ASE) and assessed weekly during the taper phase. The 21-item Hamilton Rating Scale for Depression was used to evaluate depressive symptoms. RESULTS: In the taper phase, there were no significant differences between the sertraline- and placebo-treated women on the sum of the ASE-derived symptoms. Both groups had low levels of symptoms on the ASE during the weeks of taper. None of the 3 women assigned to placebo and 2 of the 8 women assigned to sertraline suffered a depressive recurrence within 6 weeks of the end of the study. CONCLUSIONS: A gradual taper of sertraline (75 mg) over 3 weeks did not lead to discontinuation syndrome; however, the systematic dissection of symptoms resulted in our conclusion that the duration of preventive therapy should be extended to 26 weeks (about 6 months) in subsequent randomized trials, consistent with the treatment guidelines for a single episode of depression.
机译：目的：在一项随机试验的背景下，将停药综合征的特征与主要抑郁症的复发区别开来。方法：我们进行了一项随机临床试验，比较了舍曲林和安慰剂预防复发的产后DSM-IV重度抑郁症的疗效。在最初的17周积极治疗试验中抑郁症未复发的女性，将继续接受治疗，进入锥形阶段（第18-20周）。在第17周时，仍有3名妇女分配给安慰剂，8名妇女分配给舍曲林。从25项Asberg副作用评定量表（ASE）中提取了九种表征停药综合征的症状，并在锥度阶段每周进行评估。汉密尔顿抑郁量表的21个项目用于评估抑郁症状。结果：在锥度阶段，舍曲林和安慰剂治疗的妇女在ASE引起的症状总和上没有显着差异。两组在逐渐减少的一周内在ASE上的症状水平都很低。在研究结束后的6周内，分配给安慰剂的3名妇女和分配给舍曲林的8名妇女中没有2名患有抑郁症复发。结论：舍曲林（75 mg）在3周内逐渐减少不会导致停药综合征。然而，症状的系统剖析得出了我们的结论，即在随后的随机试验中，预防性治疗的持续时间应延长至26周（约6个月），与单次抑郁症的治疗指南一致。

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