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首页> 外文期刊>The journal of clinical psychiatry >Preventing depression after stroke: Results from a randomized placebo-controlled trial.
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Preventing depression after stroke: Results from a randomized placebo-controlled trial.

机译：预防中风后抑郁：来自随机安慰剂对照试验的结果。

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OBJECTIVE: We designed this study to determine whether the daily treatment of nondepressed acute stroke patients with sertraline reduced the incidence of depression at follow-up. METHOD: 111 patients with recent stroke (< 2 weeks; International Classification of Diseases, Tenth Revision criteria) were randomly assigned to treatment with placebo (N = 56) and sertraline (N = 55, 50 mg once daily) in this double-blind, placebo-controlled 24-week clinical trial. Subjects were recruited from the 2 largest teaching hospitals of Western Australia between June 2002 and June 2004. The primary endpoint of interest was development of clinically significant depressive symptoms as assessed by a Hospital Anxiety and Depression Scale-depression subscale score of 8 or above, or as diagnosed by the treating physician during 24 weeks. RESULTS: There was no significant difference in the incidence of depressive symptoms during 24 weeks of treatment (16.7% [8/48] sertraline vs. 21.6% [11/51] placebo, rate ratio = 0.8, 95% CI = 0.3 to 2.1, p = .590). The trial medication was discontinued by 51.8% (29/56) of patients assigned placebo and 47.3% (26/55) assigned sertraline (p = .634), most often because of perceived side effects or because the treating physician introduced an antidepressant medication. CONCLUSIONS: Twenty-four-week treatment with 50 mg of sertraline once daily initiated within 2 weeks of onset of acute stroke is not a significantly more effective strategy to prevent 6-month depression than usual care plus placebo among nondepressed stroke patients. New pharmacologic and nonpharmacologic strategies need to be developed to reduce the health and financial burden associated with depression after stroke.
机译：目的：我们设计了这项研究，以确定每日服用舍曲林的非抑郁急性卒中患者的每日治疗是否可降低随访中抑郁的发生率。方法：在该双盲患者中，将111例近期卒中（<2周;国际疾病分类，第十次修订标准）患者随机分配接受安慰剂（N = 56）和舍曲林（N = 55，每天50 mg）治疗，安慰剂对照的24周临床试验。受试者从2002年6月至2004年6月间从西澳大利亚州的2家最大的教学医院中招募。主要关注终点是临床上显着的抑郁症状的发展，该症状的医院焦虑和抑郁量表-抑郁量表评分低于或等于8，或者由主治医生在24周内诊断。结果：治疗24周期间抑郁症状的发生率无显着差异（舍曲林为16.7％[8/48]，安慰剂为21.6％[11/51]，比率为0.8，95％CI = 0.3至2.1 ，p = .590）。分配安慰剂的患者中有51.8％（29/56）的患者停用了该试验药物，而舍曲林的患者中有47.3％（26/55）的患者停用了该药物（p = .634），通常是因为存在副作用或主治医生引入了抗抑郁药。结论：在非中风患者中，在急性中风发作后2周内每天开始使用50 mg舍曲林的24周治疗，比常规护理加安慰剂预防6个月抑郁症的效果并不明显。需要开发新的药理学和非药理学策略，以减少与中风后抑郁相关的健康和财务负担。

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