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首页> 外文期刊>The journal of clinical psychiatry >Pilot study of augmentation with aripiprazole for incomplete response in late-life depression: getting to remission.
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Pilot study of augmentation with aripiprazole for incomplete response in late-life depression: getting to remission.

机译：阿立哌唑增强治疗对晚期抑郁症反应不完全的初步研究：缓解。

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OBJECTIVE: To determine the feasibility and safety of aripiprazole augmentation for incomplete response to sequential selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) pharmacotherapy in late-life depression. METHOD: This study was a 12-week, open-label pilot study of 24 patients (recruited from June 1, 2006, to June 1, 2007) aged 65 years and above (mean, 73.9 years) diagnosed with major depressive disorder (MDD) (according to DSM-IV) who responded partially (17-item Hamilton Rating Scale for Depression [HAM-D-17] score of 11 to 15) or not at all (HAM-D score > 15) to a 16-week trial of escitalopram (up to 20 mg/day), followed by either duloxetine (up to 120 mg/day) or venlafaxine (up to 225 mg/day) for 12 weeks. Subjects received 2.5 to 15 mg per day of adjunctive aripiprazole (mean dose, 9.0 mg/day) for 12 weeks. The criterion for remission during treatment with aripiprazole was a HAM-D score < or = 10 for 2 consecutive weeks. RESULTS: Of 24 subjects in the intent-to-treat study group, 19 completed 12 weeks of augmentation with aripiprazole, 12 of 24 (50%) met criteria for remission, and 2 of 24 discontinued due to side effects (sedation, akathisia). The mean (SD) HAM-D score decreased significantly by 6.4 (5.8) points (paired t test for means, p < .01, df = 16). There were no relapses among the 12 subjects who participated in continuation treatment over a median period of 27.6 weeks. CONCLUSIONS: In older adults with MDD with incomplete response to SSRI and SNRI pharmacotherapy, aripiprazole was well tolerated, and symptoms of depression improved significantly during treatment with aripiprazole. A randomized, double-blind, placebo-controlled trial of adjunctive aripiprazole for incomplete response in late-life depression is warranted to further evaluate benefit and risk. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00177671.
机译：目的：确定阿立哌唑增强药物对序贯选择性5-羟色胺再摄取抑制剂（SSRI）和5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）药物治疗在晚期抑郁症中的不完全反应的可行性和安全性。方法：这项研究是一项为期12周的开放标签试验研究，研究对象为24位年龄在65岁及以上（平均73.9岁）的被诊断为重度抑郁症（MDD）的患者（从2006年6月1日至2007年6月1日招募） ）（根据DSM-IV），在16周内做出部分响应（汉密尔顿抑郁量表[HAM-D-17]评分为11至15）或完全不回答（HAM-D评分> 15）依他普仑（最高20毫克/天）的试验，然后是度洛西汀（最高120毫克/天）或文拉法辛（最高225毫克/天），为期12周。受试者每天接受2.5至15毫克的阿立哌唑辅助治疗（平均剂量为9.0毫克/天），持续12周。阿立哌唑治疗期间缓解的标准是连续2周HAM-D得分<或= 10。结果：意向治疗研究组中的24名受试者中，有19名完成了阿立哌唑的增强治疗12周，其中24名（50％）达到缓解标准，而24名中有2名因副作用（镇静，静坐不全）而中止。平均（SD）HAM-D得分显着下降6.4（5.8）分（均数的t检验配对，p <.01，df = 16）。参加持续治疗的12位受试者中位27.6周没有复发。结论：在对SSRI和SNRI药物治疗反应不完全的MDD老年人中，阿立哌唑耐受性良好，阿立哌唑治疗期间抑郁症状明显改善。随机，双盲，安慰剂对照的阿立哌唑治疗晚期抑郁症反应不完全的临床研究有必要进一步评估其获益和风险。试验注册：clinicaltrials.gov标识符：NCT00177671。

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