利培酮辅助治疗难治性抑郁症对患者血小板5-羟色胺浓度的影响

目的探索小剂量利培酮合并抗抑郁剂对难治性抑郁症患者血小板5-羟色胺(5-HT)浓度的影响。方法38例难治性抑郁症患者在合并利培酮治疗前及治疗后4周末分别检测患者外周血血小板5-HT浓度,并评估汉密顿抑郁量表17项(HAMD17)、汉密顿焦虑量表(HAMA)。结果在合并利培酮治疗后血小板5-HT浓度减低,与合并治疗前相比,接近显著变化水平(P=0.05),治疗后HAMD、HAMA总分及各因子分与治疗前相比有显著差异(P<0.05);合并利培酮治疗后患者血小板5-HT浓度与本次病程、HAMD阻滞因子分、HAMA总分与精神焦虑因子分呈正相关,与HAMD总分减分值及睡眠因子减分值呈负相关;治疗前后5-HT浓度差值与发作次数负相关,与HAMD阻滞因子减分值正相关。结论小剂量利培酮合并抗抑郁剂对难治性抑郁症患者治疗4周症状有改善,同时可能引起患者血小板5-HT浓度减低;血小板内5-HT浓度与焦虑症状、阻滞等症状可能相关;血小板5-HT浓度降低与患者的阻滞症状改善可能存在一定的关系。

As an augmentative management strategy for treatment - resistant depression, risperidone may influence the platelet serotonin concentration

Objective: To explore the effect of low dose risperidone combined with antidepressants on the concentration of platelet serotonin in treatment-resistant depression patients. Methods: Before and 4 weeks after risperidone was added, the serotonin concentrations were measured and Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores were rated for the 38 treatment-resistant depression patients. Results:The serotonin concentrations at the end of week 4 after risperidone was added were mostly lower than those from baseline measurements (P=0.05). The total scores of HAMD, HAMA, and their factor scores at the end of week 4 after risperidone was added were significantly lower than the baseline scores(P<0.05). The serotonin concentrations after risperidone augmentation were positively correlated to the current episode duration, retardation scores of HAMD, the total scores of HAMA, and the mental anxiety scores of HAMA were negatively correlated to the reductions of HAMD and sleeping factor scores. The difference range between the two serotonin concentration measurements was negatively correlated to the episode frequency but positively correlated to the reductions of retardation scores of HAMD. Conclusion:When treatment-resistant depression patients response to the augmentative strategy of low dose risperidone combined with antidepressants, the serotonin concentration in the platelet may decrease. The platelet serotonin concentrations may correlate to some symptoms such as anxiety and retardation. There may be correlation between the deductions of the platelet serotonin concentrations and the improvement of the retardation symptoms.