摘要
目的探讨不同剂量阿立哌唑对五羟色胺再摄取抑制剂类(selective serotonin reuptake inhibitor,SSRIs)抗抑郁剂所致高泌乳素血症(hyperprolactinemia,HPL)的影响及安全性。方法入组135例SSRIs抗抑郁剂所致HPL抑郁症患者,随机分为3组,最终完成干预95例。在维持原SSRIs抗抑郁剂治疗基础上,研究1组(33例)使用阿立哌唑5 mg/d,研究2组(32例)使用阿立哌唑10mg/d,对照组(30例)不使用其他药物,3组均联合认知行为疗法(cognitive behavioral therapy,CBT),治疗12周。分别在入组前及治疗4周、8周、12周末监测血清泌乳素水平,并采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、功能总体评定量表(global assessment function,GAF)评估疗效,采用药物副反应评定量表(treatment emergent symptom scale,TESS)评估不良反应。结果治疗4周、8周、12周末,研究1组和研究2组泌乳素水平均低于对照组(P<0.05),治疗8周、12周末,研究1组和研究2组HAMD评分均低于对照组(P<0.01),治疗4周、8周、12周末,研究1组和研究2组GAF评分均高于对照组(P<0.01),但研究1组和研究2组的泌乳素水平、HAMD评分及GAF评分差异无统计学意义(P>0.05)。3组不良反应发生率差异无统计学意义(P>0.05)。结论阿立哌唑能够降低SSRIs抗抑郁剂所致HPL抑郁症患者的血清泌乳素水平,同时对抗抑郁治疗也具有一定增效作用。
Objective To investigate the effect and safety of different doses of aripiprazole on hyperprolactinemia(HPL) induced by antidepressants such as Selective Serotonin Reuptake Inhibitor(SSRIs). Methods One hundred and thirty-five depressive patients with SSRIs antidepressant-induced hyperprolactinemia were randomly divided into three groups and 95 cases who finished the study were included in the study. Thirty-three cases in group 1 were treated with aripiprazole 5 mg/d, thirty-two cases in group 2 were treated with aripiprazole 10 mg/d and thirty cases in control group were treated with SSRI alone. All three groups also received cognitive behavioral therapy in addition to antidepressants for 12 weeks. Serum prolactin levels were examined before admission and 4, 8 and 12 weeks after treatment. Hamilton Depression Scale(HAMD), Global Assessment Function(GAF) and Treatment Emergent Symptom Scale(TESS) were used to evaluate the efficacy and adverse reactions. Results At the end of the 4, 8 and 12 weeks, the serum prolactin level in group 1 and group 2 were significantly lower than those in control group(P <0.05). At the end of 8 and 12 weeks, the HAMD scores of group 1 and 2 group were significantly lower than those of the control group(P<0.01). At the end of 4,8, and 12 weeks, the GAF scores of group 1 and 2 group were significantly higher than those of the control group(P <0.01). However, there were no significant differences in prolactin levels, HAMD and GAF scores between group 1 and group 2(P>0.05). There was no significant difference in the rate of adverse reaction among the three groups(P>0.05).Conclusion Aripiprazole can reduce the hyperprolactinemia caused by SSRIs antidepressants and synergistically enhance efficacy of antidepressant.
作者
顾春红
姚琳
薛雪
GU Chunhong;YAO Lin;XUE Xue(Nanhui Mental Health Center,Pudong New Area,Shanghai 201399,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2019年第10期607-612,共6页
Chinese Journal of Nervous and Mental Diseases
基金
上海市卫计委科研课题面上项目（编号：201740309）
上海市浦东新区卫生系统重点专科建设（编号：PWZzk2017-27)
