抑郁症患者的治疗用药分析

目的了解该院住院抑郁症患者精神药物的临床使用情况。方法使用一日法对该院2012年抑郁症住院患者的精神药物处方进行调查。结果药物治疗抑郁症的方案有13种,联用抗抑郁药、抗精神病药和心境稳定剂88例（72.73%）;使用的抗抑郁药均为新型抗抑郁药,其中舍曲林使用频率最高（29.75%）;使用抗精神病药94例（77.69%）,其中奥氮平使用频率最高（27.27%）;抗焦虑药以苯二氮卓艹卓为主,阿普唑仑与劳拉西泮共占59.50%（72/121）。结论该院抗抑郁药的使用能够做到个体化用药,治疗抑郁症方案合理、有效。     

2004—2008年我院抗抑郁药用药分析

目的了解本院抗抑郁药应用情况及用药趋势,促进临床合理用药。方法根据抗抑郁药的结构及作用机制不同进行分类,采用WHO推荐的限定日剂量（Definded Daily Dose,DDD）频度分析法,对我院2004-2008年临床应用的抗抑郁药进行统计分析。结果我院使用的5类（共11个品种）抗抑郁药中,以选择性5．羟色胺再摄取抑制剂为临床首选药物,其使用频度及金额均居前位。结论我院使用的抗抑郁药就品种结构而言基本是合理的,总体用药频度及金额趋于平稳增长。     

Enantiospecific assay of citadiol--a key intermediate of escitalopram by liquid chromatography on Chiralpak AD-H column connected with UV and polarimetric detectors in series

A simple, rapid, selective and reproducible LC method for separation and quantitative determination of citadiol (CTD), a key intermediate of escitalopram has been developed. An optimum resolution > 3.0 was achieved on Chiralpak AD-H (250 mm x 4.6 mm); 5 microm column connected with UV and polarimetric detectors in series. The effects of organic modifiers, viz., methanol, ethanol, n-propanol and 2-propanol on enantioselectivity were evaluated. The limits of detection (LOD) and quantification (LOQ) were 0.02 microg/ml, 0.03 microg/ml and 0.07 microg/ml, 0.10 microg/ml for R-CTD and S-CTD enantiomers, respectively. The linearity of the method was studied in the range of 0.07-300 microg/ml and 0.1-300 microg/ml for R-CTD and S-CTD, respectively and the r2 was > or = 0.9999. The inter- and intra-day assay precision was less than 0.74% (%R.S.D.) and the recoveries were in the range 99.68-100.72% with %R.S.D. < 0.49%.     

Serotonin 1A Receptor Binding of [11C]CUMI-101 in Bipolar Depression Quantified Using Positron Emission Tomography: Relationship to Psychopathology and Antidepressant Response

BackgroundThe pathophysiology of bipolar disorder (BD) remains largely unknown despite it causing significant disability and suicide risk. Serotonin signaling may play a role in the pathophysiology, but direct evidence for this is lacking. Treatment of the depressed phase of the disorder is limited. Previous studies have indicated that positron emission tomography (PET) imaging of the serotonin 1A receptor (5HT1AR) may predict antidepressant response.MethodsA total of 20 participants with BD in a current major depressive episode and 16 healthy volunteers had PET imaging with [¹¹C]CUMI-101, employing a metabolite-corrected input function for quantification of binding potential to the 5HT1AR. Bipolar participants then received an open-labeled, 6-week clinical trial with a selective serotonin reuptake inhibitor (SSRI) in addition to their mood stabilizer. Clinical ratings were obtained at baseline and during SSRI treatment.ResultsPretreatment binding potential (BP_F) of [¹¹C]CUMI-101 was associated with a number of pretreatment clinical variables within BD participants. Within the raphe nucleus, it was inversely associated with the baseline Montgomery Åsberg Rating Scale (P = .026), the Beck Depression Inventory score (P = .0023), and the Buss Durkee Hostility Index (P = .0058), a measure of lifetime aggression. A secondary analysis found [¹¹C]CUMI-101 BP_F was higher in bipolar participants compared with healthy volunteers (P = .00275). [¹¹C]CUMI-101 BP_F did not differ between SSRI responders and non-responders (P = .907) to treatment and did not predict antidepressant response (P = .580). Voxel-wise analyses confirmed the results obtained in regions of interest analyses.ConclusionsA disturbance of serotonin system function is associated with both the diagnosis of BD and its severity of depression. Pretreatment 5HT1AR binding did not predict SSRI antidepressant outcome.The study was listed on clinicaltrials.gov with identifier {"type":"clinical-trial","attrs":{"text":"NCT02473250","term_id":"NCT02473250"}}NCT02473250.     

精神障碍患者出院处方中抗抑郁药的分析

目的分析我院抗抑郁药的临床使用和合理用药情况。方法随机抽查我院2007年10～12月出院带药处方,采用限定日剂量(DDD)和药物利用指数(DUI)对抗抑郁药物的使用进行了回顾性分析。结果SSRIs类抗抑郁剂使用频率较高。在联合用药方面,抗抑郁药主要是和抗精神病药物、镇静催眠药、心境稳定剂并用。在使用的13种抗抑郁药中除氟西汀和曲唑酮外,其余药物的DUI均≤1.0。结论我院抗抑郁药物的使用基本合理,且新型抗抑郁药的应用越来越多。     

Antidepressant-like effect of peony glycosides in mice

AIM OF THE STUDY: The root part of Paeonia lactiflora Pall. (Ranunculaceae), known as peony, is often used in Chinese herbal formulae for the treatment of depression-like disorders. Previous studies in our laboratory have shown that an ethanol extract of peony produced antidepressive effects in mouse models of depression. It is well known that peony contains glycosides such as paeoniflorin and albiflorin, yet it remains unclear whether the total glycosides of peony (TGP) are effective. The present study aims to evaluate the antidepressant-like effects of TGP. MATERIALS AND METHODS: The antidepressant-like effects of TGP was determined by using animal models of depression including forced swim and tail suspension tests. The acting mechanism was explored by determining the effect of TGP on the activities of monoamine oxidases. RESULTS: Intragastric administration of TGP at 80 and 160mg/kg for seven days caused a significant reduction of immobility time in both forced swim and tail suspension tests, yet TGP did not stimulate locomotor activity in the open-field test. In addition, TGP treatment antagonized reserpine-induced ptosis and inhibited the activities of monoamine oxidases in mouse cerebrum. CONCLUSION: These results suggest that the antidepressive effects of TGP are mediated, at least in part, by the inhibition of monoamine oxidases.     

抗抑郁药物联合疏肝调神针法对老年脑卒中后抑郁症患者生活质量的影响

目的：分析抗抑郁药物联合疏肝调神针法对老年脑卒中后抑郁症患者生活质量的影响。方法：88例老年脑卒中后抑郁症患者随机分成治疗组和对照组各44例,治疗组给予抗抑郁药物联合疏肝调神针法治疗,对照组给予单纯抗抑郁药物治疗,治疗后比较两组患者的临床疗效和生活质量。结果：治疗组显效率、有效率均高于对照组,差异均有统计学意义（P〈0.05）;治疗组患者治疗1月、3月、5月后的生活质量评分均高于对照组,差异均有统计学意义（P〈0.05）;治疗组患者治疗后在心理、社会、躯体及生活方面得分均高于对照组,差异有统计学意义（P〈0.05）。结论：抗抑郁药物联合疏肝调神针法对老年脑卒中后抑郁症患者有明显的治疗效果,对患者的生活质量有显著的提高,且安全性好,值得推荐临床使用。     

绞股蓝提取物抗抑郁活性研究

目的考察绞股蓝提取物抗抑郁活性。方法通过3种动物模型,即小鼠悬尾实验(TST)、强迫游泳实验(FST)和开场实验(OFT)模型,首次测试绞股蓝75%乙醇提取物(醇提物,JE)及其水提物(JW)的抗抑郁活性。结果 JE(2.5,5 g/kg)可使小鼠在TST及FST的不动时间均显著性缩短(P<0.05),呈现出良好的量效关系,且与阳性药盐酸氟西汀(FH)相比无显著性差异(P>0.05),而JW(2.5,5 g/kg)对小鼠在TST及FST的不动时间均无显著性差异(P>0.05);各组小鼠OFT穿格次数比较,均无显著性差异(P>0.05)。结论首次证实绞股蓝醇提物具有抗抑郁活性,且与FH的作用相当,而其水提物在既定给药方案下无抗抑郁活性。     

Effects of triiodothyronine and imipramine on basal 5-HT levels and 5-HT(1) autoreceptor activity in rat cortex

Clinical studies have shown that triiodothyronine (T3) both augments and accelerates the therapeutic response to antidepressant drugs, particularly tricyclics. There is evidence that this effect is mediated by the serotonergic system. We show here that T3 administered daily for 7 days over the range 0.02-0.5 mg/kg increases basal serotonin (5-hydroxytryptamine, 5-HT) levels, as measured by in vivo microdialysis in rat cortex, in a dose-dependent fashion. All the doses of T3 examined reduced 5-HT(1A) autoreceptor activity, as measured by the effect of 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT, 0.05 mg/kg s.c.) to decrease 5-HT levels in frontal cortex. T3 administered daily for 14 days at 0.02 mg/kg also reduced 5-HT(1B) autoreceptor activity, as measured by the effect of locally administered 3-(1,2,5,6-tetrahydropyrid-4-yl)pyrrolo[3,2-b]pyrid-5-one (CP 93129, 10 microM) to decrease 5-HT levels. In animals administered imipramine (10 mg/kg/day by osmotic minipump) concurrently with T3 injections, no further changes in either 5-HT(1A) or 5-HT(1B) autoreceptor activity were seen. We suggest that the effect of T3 to accelerate the therapeutic actions of antidepressant drugs may be due to a combination of the actions of T3 at autoreceptors and the actions of the drugs at postsynaptic 5-HT(1A) receptors.     

2004～2008年我院抗抑郁药利用分析

目的：评价我院门诊患者抗抑郁药的应用现状与发展趋势,为临床合理用药提供参考。方法：对2004～2008年我院门诊患者使用抗抑郁药的种类、销售金额、用药频度（DDDs）等进行回顾性分析。结果：抗抑郁药销售金额及DDDs等逐年增长,5-羟色胺再摄取抑制剂（SSRI）和5-羟色胺与去甲肾上腺素再摄取双重抑制剂（SNaRI）是临床治疗抑郁症的首选药物。结论：本院的抗抑郁药应用基本合理。SSRI和SNaRI类抗抑郁药的应用在5年中占主导地位,三环类抗抑郁药（TCA）应用较少。