拉莫三嗪对海洛因依赖者抑郁及焦虑障碍的治疗作用

目的:确定拉莫三嗪治疗海洛因依赖者抑郁、焦虑障碍的效果。方法:符合CCMD-2-R海洛因依赖者伴发焦虑症、抑郁性神经症诊断标准的72例病人随机分为2组,拉莫三嗪组及黛力新组(对照组),治疗前、治疗后1周末、3周末、5周末对两组病人进行HAMD及HAMA评分。结果:拉莫三嗪组的抗抑郁及焦虑作用于用药后第5周效果明显,用药后第1周及第3周其抗抑郁不如黛力新(P<0.05),而用药后第5周与黛力新无明显差异(P>0.05)。结论:拉莫三嗪有效地缓解海洛因依赖者焦虑抑郁障碍。     

常规治疗与合用帕罗西汀治疗功能性消化不良伴抑郁焦虑障碍的临床疗效观察

目的:观察常规治疗与合用帕罗西汀治疗功能性消化不良(FD)伴抑郁焦虑障碍的临床疗效。方法:将82例FD伴抑郁焦虑障碍患者随机分为常规治疗(常规组)和抗抑郁药+常规治疗(抗抑郁组) ,疗程均为4wk ,观察治疗前、后FD症状评分及汉密顿抑郁量表(HAMD)、Zung抑郁自评量表(SDS)、焦虑自评量表(SAS)评分变化。结果:女性患者占81.7 % ,显著多于男性的18. 3 %(P<0 .01) ;治疗后抗抑郁组各项评分均显著下降(P<0 .01) ,而常规组则无明显改变(P>0. 05) ;抗抑郁组FD疗效及HAMD、SAS评分达常模范围的疗效与常规组比较有显著性差异(P<0. 01)。结论:常规治疗合用帕罗西汀,既能显著改善FD症状,又能有效控制抑郁焦虑障碍。     

补心丸对糖尿病伴抑郁焦虑症患者抑郁症状的影响

目的:观察补心丸对糖尿病伴抑郁焦虑症患者抑郁症状的影响。方法:45例糖尿病伴抑郁焦虑症患者按随机数字表法分为试验组(25例)和观察组(20例)。试验组给予补心丸9 g,口服,tid;观察组患者给氟伏沙明d1-325 mg,d4-650 mg,d775 mg,每晚饭后服用,qd。两组患者疗程均为30 d。另选择20名健康志愿者作为对照组。观察两组患者治疗前后汉密尔顿抑郁量表(HAMD-17)评分、汉密尔顿焦虑量表(HAMA)评分、匹兹堡睡眠质量指数(PSQI)、简易智力状态检查表(MMSE)评分、血清褪黑素水平及不良反应发生情况,并与对照组进行比较。结果:治疗前两组患者HAMD-17评分、HAMA评分、PSQI、血清褪黑素水平比较,差异均无统计学意义(P>0.05),但HAMD-17评分、HAMA评分、PSQI均显著高于对照组,血清褪黑素水平显著低于对照组,差异有统计学意义(P<0.05);治疗后两组患者HAMD-17评分、HAMA评分、PSQI均显著低于同组治疗前,血清褪黑素水平显著高于同组治疗前,差异有统计学意义(P<0.05),但三组间比较除血清褪黑素水平显著高于对照组外(P<0.05),HAMD-17评分、HAMA评分、PSQI、MMSE评分比较,差异均无统计学意义(P>0.05)。试验组患者不良反应发生率显著低于观察组,差异有统计学意义(P<0.05)。结论:补心丸可显著增加糖尿病伴抑郁焦虑症患者血清褪黑素水平,改善患者的抑郁症状,且安全性较好。     

利培酮对焦虑抑郁共病的疗效比较

目的观察利培酮联合氟西汀对焦虑抑郁共病的疗效和安全性。方法86例焦虑抑郁共病患者随机分为研究组(利培酮 氟西汀)44例、对照组(氟西汀)42例,治疗8周。于治疗前、治疗后每2周测评汉密尔顿抑郁量表(HAMD)24项、汉密尔顿焦虑量表(HAMA)、治疗中需处理的不良反应量表(TESS)。疗效评价以HAMD减分率为标准,不良反应以TESS评分为标准。结果两组HAMD、HAMA评分组间比较从第2周周末开始差异有显著性(P<0.05、P<0.01),两组疗效比较差异有显著性(P<0.05),各时期TESS评分比较差异无显著性(P>0.05)。结论利培酮联合氟西汀治疗焦虑抑郁共病的疗效和安全性较好。     

脑卒中患者伴发抑郁焦虑情绪的临床治疗

目的验证氟西汀对脑卒中患者伴发抑郁焦虑情绪的治疗作用。方法采用抑郁自评量表(SDS)、焦虑自评量表(SA S),先取伴抑郁、焦虑情绪的脑卒中患者70例,随机分为二组。治疗组:每日口服氟西汀20m g,共4周,于治疗后进行SDS、SA S测评,并与对照组进行对照。结果氟西汀治疗脑卒中患者伴发的抑郁、焦虑情绪有效率分别为81.25%和81.26%,明显高于对照组。结论氟西汀对脑卒中患者的抑郁、焦眠情绪均有明显治疗作用。     

米氮平治疗伴有焦虑的抑郁症

目的评价米氮平治疗伴有焦虑的抑郁症的疗效及安全性。方法60例伴有焦虑的抑郁症患者分为两组。治疗组29例，均给予米氮平15～45 mg·d^-1，对照组31例，均给予阿密替林100～200 mg·d^-1，共治疗6周。采用汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）评定临床疗效，不良反应量表（TESS）评定不良反应。结果对抑郁症状的治疗，治疗组显效率为72.4%，对照组显效率为71.0%（P＞0.05）;对焦虑症状的治疗，治疗组显效率为79.3%，对照组显效率为51.6%（P＜0.01）。治疗组治疗第1周就起效。治疗组的不良反应比对照组少而轻，常见的有口干、 嗜睡、体重增加、肠胃不适等。结论米氮平治疗抑郁症效果好，起效快，抗焦虑作用优于阿密替林。     

Association of Oxidative Stress to the Genesis of Anxiety: Implications for Possible Therapeutic Interventions

Oxidative stress caused by reactive species, including reactive oxygen species, reactive nitrogen species, and unbound, adventitious metal ions (e.g., iron [Fe] and copper [Cu]), is an underlying cause of various neurodegenerative diseases. These reactive species are an inevitable by-product of cellular respiration or other metabolic processes that may cause the oxidation of lipids, nucleic acids, and proteins. Oxidative stress has recently been implicated in depression and anxiety-related disorders. Furthermore, the manifestation of anxiety in numerous psychiatric disorders, such as generalized anxiety disorder, depressive disorder, panic disorder, phobia, obsessive-compulsive disorder, and posttraumatic stress disorder, highlights the importance of studying the underlying biology of these disorders to gain a better understanding of the disease and to identify common biomarkers for these disorders. Most recently, the expression of glutathione reductase 1 and glyoxalase 1, which are genes involved in antioxidative metabolism, were reported to be correlated with anxiety-related phenotypes. This review focuses on direct and indirect evidence of the potential involvement of oxidative stress in the genesis of anxiety and discusses different opinions that exist in this field. Antioxidant therapeutic strategies are also discussed, highlighting the importance of oxidative stress in the etiology, incidence, progression, and prevention of psychiatric disorders.     

Herbal Medicine for Anxiety,Depression and Insomnia

The prevalence and comorbidity of psychiatric disorders such as depression, anxiety and insomnia are very common. These well-known forms of psychiatric disorders have been affecting many people from all around the world. Herb alone, as well as herbal formula, is commonly prescribed for the therapies of mental illnesses. Since various adverse events of western medication exist, the number of people who use herbs to benefit their health is increasing. Over the past decades, the exploration in the area of herbal psychopharmacology has received much attention. Literatures showed a variety of herbal mechanisms of action used for the therapy of depression, anxiety and insomnia, involving re-uptake of monoamines, affecting neuroreceptor binding and channel transporter activity, modulating neuronal communication or hypothalamic-pituitary adrenal axis (HPA) etc. Nonetheless, a systematic review on herbal pharmacology in depression, anxiety and insomnia is still lacking. This review has been performed to further identify modes of action of different herbal medicine, and thus provides useful information for the application of herbal medicine.     

氟哌噻吨/美利曲辛与帕罗西汀治疗以躯体化表现就诊的焦虑/抑郁患者的疗效观察

目的:观察氟哌噻吨/美利曲辛(黛力新)与帕罗西汀治疗以躯体化表现就诊的焦虑/抑郁患者的疗效及安全性。方法:对2010年1月—2010年12月以躯体化表现就诊的考虑焦虑/抑郁可能的患者,使用汉密尔顿抑郁量表17项表(HAMD-17)、汉密尔顿焦虑量表(HAMA)进行分析,对确诊的焦虑/抑郁障碍患者给予氟哌噻吨/美利曲辛或者帕罗西汀治疗;并于治疗后第1、4周复测HAMD-17、HAMA。结果:经统计,确诊患者中有76.9%为反复就诊患者,经予氟哌噻吨/美利曲辛或者帕罗西汀治疗第4周后与治疗前比较差异显著(P<0.01,P<0.01),而两者之间差异无统计学意义(P>0.05)。经予氟哌噻吨/美利曲辛治疗1周后复测HAMD-17、HAMA评分,较治疗前相比差异均有统计学意义(P<0.05,P<0.05);而帕罗西汀组差异无统计学意义(P>0.05)。病程长者疗效欠佳。结论:以躯体化表现就诊的焦虑/抑郁患者在神经内科就诊比例较高,应对其早期识别,及时使用氟哌噻吨/美利曲辛或者帕罗西汀治疗干预可有效的缓解患者躯体症状,且无明显不良反应;此外氟哌噻吨/美利曲辛起效较帕罗西汀更快。     

Challenging sequential approach to treatment resistant depression: Cost-utility analysis based on the Sequenced Treatment Alternatives to Relieve Depression (STAR⁎D) trial

In major depression, when a first antidepressant does not cause remission of symptoms (60%–75%), there are several options for continuing treatment in the next step. This study is a cost-utility analysis (CUA) of different second-line approaches. In a simulated trial outpatients with MDD were treated with citalopram for 13 weeks (level 1), then based on two alternative algorithms implemented from the Sequenced Treatment Alternatives to Relieve Depression (STAR^*D) study. Algorithm A: citalopram was continued until study endpoint (week 26). Algorithm B: patients who remitted during level 1 continued citalopram. Those who did not remit could opt for switching to another antidepressant (venlafaxine; sertraline) (b1) or adding bupropion to citalopram treatment (augmentation; b2). Algorithm B increased remission rate by 10.6% over Algorithm A (number needed to treat: 9.9; sensitivity range: 9.1–12.5). As a comparison, differences between active antidepressants and placebo are associated with NNT values of 6 to 8. In CUA Algorithm B was dominant with an ICER of $11,813 (sensitivity range=$1783 – $21,784), which is <1 GDP per capita cost-effectiveness threshold (USA=$47,193). Among Algorithm B options, switching (b1) dominated Algorithm A with a smaller number of responders than augmentation approach (b2) (NNT 11 vs. 7.7), whereas ICER values were similar (b1: $14,738; b2: $15,458). However we cannot exclude a bias in selecting second treatment. This cost-utility analysis shows (in line with current guidelines) a benefit in modifying antidepressant treatment if response to first-line agent does not occur within 3 months, but not a clear-cut evidence in terms of NNT.     

文拉法辛缓释剂对抑郁伴发焦虑障碍患者的疗效

目的 研究文拉法辛缓释剂对抑郁伴发焦虑障碍患者的治疗效果.方法 对20例抑郁症伴发焦虑障碍患者以文拉法辛缓释剂治疗6周,平均剂量为(154±46)mg/d.在治疗前及第1、2、4、6周末评定汉密尔顿抑郁量表(17项,HAMD)和汉密尔顿焦虑量表(HAMA),并监测血压,记录不良反应.结果 文拉法辛缓释剂对抑郁伴发焦虑障碍效果良好,HAMD评分自第1周起均有显著改善,且一直持续至治疗第6周末.HAMA评分自第1周起也有显著改善.不良反应轻微.结论 文拉法辛缓释剂抗抑郁及抗焦虑作用尚可,可用于抑郁症伴发焦虑障碍的治疗.     

坦度螺酮联合西酞普兰治疗伴焦虑症状的抑郁症对照研究

目的探讨坦度螺酮联合西酞普兰治疗伴有焦虑症状的抑郁症疗效。方法将56例伴有焦虑症状的抑郁症患者随机分成两组,各28例。治疗组在用西酞普兰基础上联合使用坦度螺酮治疗,对照组仅用西酞普兰治疗,疗程6周。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效,采用药物不良反应量表(TESS)于治疗6周末评定不良反应。结果 6周末治疗组HAMD和HAMA评分低于对照组。两组不良反应无显著差异。结论坦度螺酮联合西酞普兰治疗伴有焦虑症状的抑郁症的疗效优于单用西酞普兰。     

Linalool as a Therapeutic and Medicinal Tool in Depression Treatment: A Review

Depression is a prevalent disease worldwide, limiting psychosocial functioning and thequality of life. Linalool is the main constituent of some essential oils from aromatic plants, representing about 70% of these volatile concentrates. Evidence of the linalool activity on the central nervous system, mainly acting as an antidepressant agent, is increasingly abundant. This review aimed to extend the knowledge of linalool''s antidepressant action mechanisms, which is fundamental for future research, intending to highlight this natural compound as a new antidepressant phytomedication. A critical analysis is proposed here with probable hypotheses of the synergic mechanisms that support the evidence of antidepressant effects of the linalool. The literature search has been conducted in databases for published scientific articles before December 2020, using relevant keywords. Several pieces of evidence point to the anticonvulsant, sedative, and anxiolytic actions. In addition to these activities, other studies have revealed that linalool acts on the monoaminergic and neuroendocrine systems, inflammatory process, oxidative stress, and neurotrophic factors, such as BDNF, resulting in considerable advances in the knowledge of the etiology of depression. In this context, linalool emerges as a promising bioactive compound in the therapeutic arsenal, capable of interacting with numerous pathophysiological factors and acting on several targets. This review claims to contribute to future studies, highlighting the gaps in the linalool knowledge, such as its kinetics, doses, routes of administration, and multiple targets of interaction, to clarify its antidepressant activity.     

Brain Functional Effects of Psychopharmacological Treatment in Major Depression: A Focus on Neural Circuitry of Affective Processing

In the last two decades, neuroimaging research has reached a much deeper understanding of the neurobiological underpinnings of major depression (MD) and has converged on functional alterations in limbic and prefrontal neural networks, which are mainly linked to altered emotional processing observed in MD patients. To date, a considerable number of studies have sought to investigate how these neural networks change with pharmacological antidepressant treatment. In the current review, we therefore discuss results from a) pharmacological functional magnetic resonance imaging (fMRI) studies investigating the effects of selective serotonin or noradrenalin reuptake inhibitors on neural activation patterns in relation to emotional processing in healthy individuals, b) treatment studies in patients with unipolar depression assessing changes in neural activation patterns before and after antidepressant pharmacotherapy, and c) predictive neural biomarkers of clinical response in depression. Comparing results from pharmacological fMRI studies in healthy individuals and treatment studies in depressed patients nicely showed parallel findings, mainly for a reduction of limbic activation in response to negative stimuli. A thorough investigation of the empirical findings highlights the importance of the specific paradigm employed in every study which may account for some of the discrepant findings reported in treatment studies in depressed patients.     

Strain Differences in the Chronic Mild Stress Animal Model of Depression and Anxiety in Mice

Chronic mild stress (CMS) has been reported to induce an anhedonic-like state in mice that resembles some of the symptoms of human depression. In the present study, we used a chronic mild stress animal model of depression and anxiety to examine the responses of two strains of mice that have different behavioral responsiveness. An outbred ICR and an inbred C57BL/6 strain of mice were selected because they are widely used strains in behavioral tests. The results showed that the inbred C57BL/6 and outbred ICR mice were similarly responsive to CMS treatment in sucrose intake test (SIT) and open field test (OFT). However, the two strains showed quite different responses in forced swimming test (FST) and novelty-suppressed feeding (NSF) test after 3 weeks of CMS treatment. Only C57BL/6 mice displayed the depression- and anxiety-like behavioral effects in response to CMS treatment in FST and NSF test. Our results suggest that there are differences in responsiveness to CMS according to the different types of strain of mice and behavioral tests. Therefore, these results provide useful information for the selection of appropriate behavioral methods to test depression- and anxiety-like behaviors using CMS in ICR and C57BL/6 mice.     

盐酸舍曲林治疗冠心病患者伴焦虑抑郁状态的疗效

目的 探讨盐酸舍曲林对冠心病患者焦虑、抑郁状态的影响.方法对179例冠心病伴焦虑、抑郁患者随机分为对照组87例和治疗组92例,给予冠心病常规治疗和心理治疗,治疗组同时给予盐酸舍曲林口服,25 mg起服,qd,早餐后服药,第3天加量至50 mg.疗程为8周.分别在治疗2周和治疗8周进行患者焦虑自评量表(SAS)、抑郁自评量表(SDS)、症状自评量表(SCL-90)评分和冠心病临床症状(心电图ST段改变级胸痛等)缓解情况比较.结果治疗8周后,盐酸舍曲林治疗组临床症状好转率(96.7%)较对照组(86.2%)高(P<0.05).治疗2周后和8周后治疗组和对照组SAS、SDS评分均较首次评定显著下降 (P<0.01);且治疗8周盐酸舍曲林治疗组较对照组SAS、SDS评分下降更为明显(P<0.05).SCL-90量表显示患者躯体化、抑郁和焦虑状态在治疗2周和8周均较入院时症状改善明显.结论盐酸舍曲林能明显改善冠心病患者焦虑、抑郁症状,并明显缓解冠心病患者急性期临床症状.     

Experimental anxiety and antidepressant drugs: the effects of moclobemide, a selective reversible MAO-A inhibitor, fluoxetine and imipramine in mice

Available evidence derived from behavioural and clinical studies indicates that antidepressant drugs may be effective as anxiolytic agents. In this connection, the present study was designed to assess the behavioural effects of three antidepressant drugs, i.e. imipramine (IMI), a non selective serotonin (5-HT) and noradrenaline re-uptake (NA) inhibitor, Fuoxetine (FLU), a selective 5-HT re-uptake inhibitor (SSRI) and moclobemide (MOC), a reversible inhibitor of type A monoamine-oxidase enzyme (RIMA) on anxiety, exploratory and locomotor activities in mice. The experiments used two animal models which attempt to separate these three factors: the light-dark aversion test and the open-field test. Naive female CD1 mice were administered intraperitoneally (i.p.) 30 min before testing with IMI (10, 20 and 40 mg/kg) or FLU (5, 10 and 20 mg/kg) or MOC (l, 5 and 10 mg/kg) or vehicle. Results showed that IMI (10 and 20 mg/kg), FLU (10 and 20 mg/kg) and MOC (l, 5 and 10 mg/kg) significantly reduced the aversive behavior of mice for the lit area in the light/dark aversion test, suggesting an anxiolytic-like effect. In fact, vehicle controls preferred the dark box where they spent approximately 70% of their time, indicating that light serves as an anxiogenic stimulus. Importantly, the anxiolytic-like effects of these antidepressant drugs were not associated with any increase in locomotor activity. In summary, these data suggest that FLU and the new generation of RIMA, exemplified by MOC, in terms of probable efficacy and greater safety, are of interest as treatment for a broad spectrum of anxiety disorders.     

对乙酰氨基酚肝毒性机理及药物干预靶点

由于对乙酰氨基酚用药普遍性和广泛性,其肝毒性问题日益引起人们的关注。本文介绍对乙酰氨基酚肝脏代谢、转运以及与Keap1-Nrf2通路有关的生理性调控机制,阐述对乙酰氨基酚的肝毒性机理,包括代谢损伤和氧化应激损伤两大理论。并以此为基础从吸收、代谢、转运等方面对其治疗靶点及干预药物加以综述。其中,Keap1-Nrf2抗氧化解毒通路和转运蛋白环节与对乙酰氨基酚肝毒性关系的研究在近几年逐渐增多,有望发现新的治疗靶点和对乙酰氨基酚肝毒性的有效治疗药物。     

Hesperidin,a citrus bioflavonoid,alleviates trichloroethylene-induced oxidative stress in Drosophila melanogaster

Trichloroethylene (TCE) is a chlorinated organic pollutant of groundwater with diverse toxic effects in animals and humans. Here, we investigated the ameliorative role of hesperidin, a citrus bioflavonoid on TCE-induced toxicity in Drosophila melanogaster. Four groups of D. melanogaster (50 flies/vial, with 5 vials/group) were exposed to ethanol (2.5%, control), HSP (400 mg/10 g diet), TCE (10 μM/10 g diet) and TCE (10 μM/10 g diet) + HSP (400 mg/10 g diet) respectively in the diet for 5 days. Then, selected oxidative stress and antioxidant markers were evaluated. The results showed that TCE significantly increased the level of reactive oxygen species (ROS) and inhibited catalase, glutathione S-transferase and acetylcholinesterase (AChE) activities with concurrent depletion of total thiol level. However, co-administration of TCE and hesperidin mitigated TCE-induced depletion of antioxidants, and restored ROS level and AChE activity in the flies (p < 0.05). Overall, hesperidin offered protective potency on TCE-induced oxidative stress in the flies via anti-oxidative mechanism.     

舍曲林与阿米替林治疗抑郁症的疗效比较

目的 比较舍曲林和阿米替林治疗抑郁症的疗效及不良反应。方法抑郁症患者60例，随机分为两组各30例。治疗组给予舍曲林20～40 mg·d^-1，qd， po；对照组给予阿米替林50～250 mg·d^-1，bid，po。疗程均为6周。用汉密尔顿抑郁量表(HAMD)、药物不良反应量表(TESS)进行评定。结果两组治疗抑郁症起效时间及疗效相近，治疗组和对照组有效率分别为76.7%， 70.0%(P＞0.05)；TESS评分分别为为(1.5± 1.2)，(3.4± 2.6)分( P＜0.01)。结论舍曲林治疗抑郁症与阿米替林疗效相似，但不良反应轻，用药方便。