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首页> 外文期刊>The annals of pharmacotherapy >Cholinesterase inhibitor adjunctive therapy for cognitive impairment and depressive symptoms in older adults with depression [Uso de inhibidores de colinesterasa como tratamiento adjunto en pacientes ancianos con depresión y síntomas de depresión y problemas cognitivos]
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Cholinesterase inhibitor adjunctive therapy for cognitive impairment and depressive symptoms in older adults with depression [Uso de inhibidores de colinesterasa como tratamiento adjunto en pacientes ancianos con depresión y síntomas de depresión y problemas cognitivos]

机译：胆碱酯酶抑制剂辅助治疗老年抑郁症患者的认知障碍和抑郁症状[胆碱酯酶抑制剂作为辅助治疗老年抑郁症和抑郁症及认知障碍症状的患者]

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Objective: To review the primary literature regarding the use of cholinesterase inhibitors (ChEIs) as adjunctive therapy for cognitive enhancement and improvement of depressive symptoms for older adults with depression. Data Sources: A literature search of MEDLINE (1950-September 2011) was conducted, using the search term depression in combination with cholinesterase inhibitor, donepezil, galantamine, or rivastigmine. A search of reference citations was conducted to identify additional references. Study Selection And Data Extraction: English-language clinical trials were evaluated. Studies that included subjects with Alzheimer's disease, dementia, Parkinson disease, bipolar disorder, or schizophrenia were excluded. Four clinical studies met our criteria. Data Synthesis: We identified 4 randomized, double-blind, placebo-controlled trials that ranged in sample size from 20 to 130. Galantamine 16 mg daily was evaluated in 2 trials lasting 8 and 24 weeks. Neither study found a statistically significant difference in measures of cognition or Hamilton Rating Scale for Depression scores. Donepezil augmentation was evaluated in a 1-year and a 2- year trial. Donepezil was found to improve global cognition at 1 year, but the benefit did not persist at year 2. Subjects with mild cognitive impairment at baseline who received donepezil experienced higher depression recurrence than did those who took placebo (p = 0.03); this effect was not observed in cognitively intact subjects (p = 0.39). Conclusions: There is no clear benefit for ChEI therapy as an adjunct to antidepressant therapy for depressed older adults.
机译：目的：综述有关胆碱酯酶抑制剂（ChEIs）作为辅助疗法治疗老年抑郁症成年人的认知增强和抑郁症状的主要文献。数据来源：对MEDLINE（1950年9月至2011年9月）进行文献检索，将检索词抑郁症与胆碱酯酶抑制剂，多奈哌齐，加兰他敏或利凡斯的明组合使用。进行参考文献检索以识别其他参考文献。研究选择和数据提取：对英语临床试验进行了评估。排除患有阿尔茨海默氏病，痴呆，帕金森病，双相情感障碍或精神分裂症的受试者的研究。四项临床研究符合我们的标准。数据综合：我们确定了4项随机，双盲，安慰剂对照试验，样本量从20到130不等。在2个试验中，每天服用16 mg加兰他敏，持续8和24周。两项研究均未发现认知测量或汉密尔顿抑郁量表评分的统计学差异。多奈哌齐增效在1年和2年试验中进行了评估。发现多奈哌齐可在1年时改善整体认知，但这种益处在2年时并未持续。基线时有轻度认知障碍的受试者接受多奈哌齐的抑郁症复发率高于服用安慰剂的受试者（p = 0.03）。在认知完好的受试者中未观察到这种作用（p = 0.39）。结论：对于抑郁抑郁的成年人，ChEI治疗作为抗抑郁治疗的辅助手段尚无明显益处。

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