Parotid gland flow activity and inorganic composition in purging bulimic patients treated with fluoxetine

Abstract

Objectives. The purpose of this study was to establish whether vomiting bulimic and/or non-bulimic depressive patients, both treated with the serotonin reuptake inhibitor SI-5-HT (fluoxetine), have differing proportions of inorganic components (specifically, sodium, potassium and calcium) in their parotid salivary gland secretions, than in the average population. Methods. A controlled clinical trial was designed for three age-matched female groups: bulimic patients receiving fluoxetine 40 mg/day (n = 33), non-bulimic patients diagnosed with bipolar affective disorder (fluoxetine 20 mg/day, n = 25) and healthy controls (n = 51). Parotid saliva was collected using a Lashley cap while the subjects were at rest. Stimulation was obtained chemically using a 3% citric acid solution, and physically by instructing the subjects to chew on wax pellets. The concentrations of sodium, potassium and calcium ions were measured using the colorimetric photometry method. Results. The bulimic patients had a reduction in flow and sodium and potassium ions in the parotid saliva and non-bulimic patients had a reduction in flow. Deficits in certain components of saliva were shown to be directly related to salivary flow rate. Conclusions. The data suggest that detection of inorganic deficits in parotid saliva might serve as a reliable confirmation of reduction in flow amongst purging bulimic patients treated with fluoxetine.     

阿米替林联合氟西汀治疗抑郁症的临床研究

目的探讨盐酸阿米替林片联合盐酸氟西汀分散片治疗抑郁症的临床疗效。方法选取2016年1月—2017年6月重庆市精神卫生中心收治的抑郁症患者100例为研究对象,将所有患者依照随机信封法分为对照组和治疗组,每组各50例。对照组口服盐酸氟西汀分散片,初始剂量20 mg/次,1次/d,依照病情变化情况适当增加剂量,最大剂量60 mg/d。治疗组在对照组治疗的基础上口服盐酸阿米替林片,75 mg/d,2次/d。两组患者均连续治疗3个月。观察两组的临床疗效,比较两组的甲状腺功能和汉密顿抑郁量表(HAMD)评分。结果治疗后,对照组和治疗组的总有效率分别为84.00%、98.00%,两组比较差异具有统计学意义(P0.05)。治疗后,两组三碘甲状原氨酸素(T3)、甲状腺素(T4)水平均显著降低,促甲状腺素(TSH)水平显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组甲状腺功能指标水平明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组HAMD评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组HAMD评分明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论盐酸阿米替林片联合盐酸氟西汀分散片治疗抑郁症具有较好的临床疗效,可降低HAMD评分,改善甲状腺功能,具有一定的临床推广应用价值。     

认知行为治疗拒绝上学的研究

目的：探讨认知行为治疗（CBT）及联合氟西汀治疗拒绝上学的疗效。方法：选择2009年10月至2012年10月符合拒绝上学诊断标准的患者95例,年龄8～18岁。将95例患者随机分为CBT组（n=47）、CBT＋氟西汀组（n=48）,疗程12周,治疗前后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）评价,记录每组的返校率。结果：CBT组治疗前后SAS和SDS比较差异有统计学意义（P〈0.01）,返校率74.5%;CBT＋氟西汀组治疗前后SAS和SDS评分比较差异有统计学意义（P〈0.01）,返校率83.3%。两组间返校率比较差异无统计学意义（P〉0.05）。结论：CBT和CBT联合氟西汀均可以有效治疗拒绝上学,氟西汀不能提高CBT治疗拒绝上学的疗效。     

艾司西酞普兰与氟西汀治疗老年抑郁症疗效对照研究

目的 比较艾司西酞普兰与氟西汀治疗老年抑郁症的疗效和安全性.方法 将70例老年抑郁症患者随机分为观察组和对照组各35例.观察组给予艾司西酞普兰治疗,对照组给予氟西汀治疗.用汉密顿抑郁量表（HAMD）评定其疗效,采用副反应量表评价安全性,分别在治疗0、1、2、4、6周末评定疗效和不良反应.结果 观察组痊愈率为68.57%高于对照组的65.71%,有效率为82.86%高于对照组的80.00%,但2组差异无统计学意义（P〉0 05）.HAMD评分2组治疗第1、2、6周均低于治疗前,观察组治疗第1周HAMD总分和睡眠障碍因子分值低于对照组,差异有统计学意义（P〈0.05）.2组不良反应的发生率比较差异无统计学意义（P〉0.05）.结论 艾司西酞普兰治疗老年抑郁症有效且安全,且起效时间早于氟西汀.     

Evidence for Pretreatment LICI Deficits Among Depressed Children and Adolescents With Nonresponse to Fluoxetine

BackgroundResearch suggests that alterations in gamma-aminobutyric acid receptor functioning have a role in depression. Paired-pulse transcranial magnetic stimulation (TMS) paradigms are noninvasive measures of cortical inhibitory and excitatory circuits.Objective/hypothesisThe present study examined pretreatment short-interval intracortical inhibition (SICI), long-interval cortical inhibition (LICI), and intracortical facilitation (ICF) in children and adolescents with major depressive disorder who were initiating fluoxetine treatment. The primary objective was to examine the relationship of these measures with subsequent treatment response. It was hypothesized that alterations in pretreatment GABA and glutamate mediated neurotransmission, would be associated with fluoxetine nonresponse.MethodsSixteen children and adolescents with major depressive disorder underwent paired-pulse TMS testing before beginning fluoxetine treatment. Response was prospectively characterized by scores of 1 or 2 on the Clinical Global Impression Scale and less than 40 on the Children's Depression Rating Scale-Revised after 6 weeks of fluoxetine treatment (20–40 mg/day).ResultsEight patients responded to treatment. Least-squares mean LICI values were consistently higher bilaterally for treatment nonresponders. Higher LICI values indicate less inhibition and impaired GABA_B functioning. There was no significant effect of treatment response on the measures of SICI and ICF.ConclusionsOur findings suggest that deficits in pretreatment GABA_B may be related to fluoxetine nonresponse in depressed youth. This is congruent with prior work demonstrating that GABA_B interneurons have serotonergic input and antidepressants modulate GABA_B receptors. These findings also show that TMS paradigms have utility in studying the neurophysiology and treatment of childhood mood disorders.RegistrationsCortical Excitability and Inhibition in Children and Adolescents With Major Depressive Disorder, http://www.clinicaltrials.gov/ct2/show/NCT00896090?term=cortical+excitability+and+inhibition&rank=2, NCT00896090; Sequential Treatment of Pediatric MDD to Increase Remission and Prevent Relapse, http://www.clinicaltrials.gov/ct2/show/NCT00612313?term=Sequential+Treatment+and+MDD&rank=1, NCT00612313.     

The effect of fluoxetine on ischemia–reperfusion after aortic surgery in a rat model

Background

Aortic ischemia–reperfusion (IR) is an important factor in the development of postoperative acute lung injury after abdominal aortic surgery. The aim of the present study was to examine the effect of fluoxetine (Flx), a selective serotonin reuptake inhibitor widely used as a preoperative anxiolytic, on lung injury induced by abdominal aortic IR in rats.

Methods

Wistar rats were randomized into three groups (n = 7 per group): (1) control (sham laparotomy); (2) IR without Flx (60-min ischemia and 120-min reperfusion); (3) IR with Flx (Flx + IR) (Flx 20 mg/kg/d, intraperitoneally for 3 d before surgery). Lung tissue samples and bronchoalveolar lavage (BAL) were obtained for biochemical analysis of oxidative status. Ischemia-modified albumin (IMA) level and protein concentrations in BAL and lung wet to dry weight ratios were determined. Histologic evaluation of the lung tissues was also performed.

Results

IR without Flx led to significant increase in lipid hydroperoxide, malondialdehyde, and pro-oxidant–antioxidant balance and decrease in superoxide dismutase, glutathione, and ferric reducing antioxidant power activities (P < 0.05 versus control), whereas Flx was able to restore these parameters (P > 0.05 versus control) and decrease IMA level (P < 0.01 versus control) and protein concentration (P < 0.05 versus control) in BAL and wet to dry lung weight ratio. Histologic evaluation showed that Flx attenuated the morphologic changes associated with lung injury.

Conclusions

The results indicate that Flx confers protection against aortic IR-induced lung oxidative stress and cellular integrity. IMA levels in BAL may be used as a follow-up marker for the efficacy of treatment in lung injury.     

HPLC手性固定相法测定血浆中氟西汀对映体的浓度

目的:建立以高效液相色谱手性固定相法测定血浆中氟西汀对映体浓度的方法。方法:采用Chirobiotic V手性色谱柱,流动相为甲醇-冰醋酸-三乙胺(100∶0.04∶0.04),检测波长为226nm,流速为1mL·min-1,内标为氯氮平。结果:R-去甲氟西汀和S-去甲氟西汀对氟西汀对映体和内标的分离没有干扰。R-氟西汀、S-氟西汀检测浓度分别在8.1~432(r=0.9998)、10.8~432(r=0.9992)ng·mL-1范围内线性关系良好;其相对回收率分别为97.2%~101.9%和98.7%~102.2%,日内RSD分别为2.6%~5.3%和2.1%~6.7%,日间RSD分别为7.7%~8.9%和8.0%~10.6%。结论:本试验所建立的方法简便、可靠、灵敏度高,可用于血浆中R-氟西汀和S-氟西汀的血药浓度测定及对映体的药动学研究。     

瑞波西汀与氟西汀治疗老年抑郁症的对照研究

目的：比较瑞波西汀与氟西汀治疗老年抑郁症的疗效和安全性。方法：用瑞波西汀与氟西汀对144例老年抑郁症患者进行为期6周的随机对照试验，用汉密顿抑郁量表（HAMD）评定疗效，用不良反应量表（TESS）评定不良反应。结果：瑞波西汀与氟西汀治疗老年抑郁症的疗效相当（P〉0.05），其显效率分别为72．3％和75％；瑞波西汀致口干、便秘、皮肤异样感等不良反应较氟西汀多，而恶心、呕吐、腹泻、嗜睡等不良反应较氟西汀少。结论：瑞波西汀治疗老年抑郁症具有良好的疗效和安全性。     

氟西汀干预脑卒中后康复的疗效观察

目的:探讨氟西汀干预急性期脑卒中后康复的作用。方法:对新发卒中病人使用氟西汀干预,并根据随机双盲的原则分成氟西汀治疗组和常规治疗对照组。在1周和4周时分别检测神经功能缺损评分、抑郁量表值以及血浆和血小板5-羟色胺浓度。结果:治疗4周后治疗组的抑郁分值较对照组降低,神经功能康复差异有显著性(P<0.05),治疗组血小板5-羟色胺浓度低于对照组。结论:早期使用小剂量氟西汀能够减少卒中后抑郁,调节神经递质,促进患者神经功能的康复。