性别对舍曲林与丙米嗪治疗慢性抑郁响应率的影响  

Effects of gender difference on response to sertraline and imipramine in patients with chronic depression

作　　者：方国栋 张丽华[2] 唐薇婷[3] FANG Guodong;ZHANG Lihua;TANG Weiting(Department of Pharmacy, Staff Hospital of Central South University, Hunan 410083, Changsha , China;Key laboratory of Nanobiotechnolgy of National Health;Department of Neurology, Xiangya Hospital of Central South University, Hunan 410087, Changsha, China)

机构地区：[1]中南大学职工医院药剂科 [2]中南大学湘雅医院卫生部纳米生物技术重点实验室 [3]中南大学湘雅医院神经内科

出　　处：《中国临床药理学与治疗学》2017年第10期1172-1179,共8页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨性别差异对选择性5-羟色胺再摄取抑制剂舍曲林和三环类药物丙米嗪治疗慢性抑郁响应率的影响。方法:于本院就诊的235例男性和400例女性且根据DSM-III-R诊断标准确诊的慢性重性抑郁或双向抑郁患者接受12周舍曲林或丙米嗪双盲治疗。结果:女性患者对舍曲林的响应率高于丙米嗪,而男性患者对丙米嗪的响应率高于舍曲林;性别和治疗方法对患者退出研究率也有限制影响,接受丙米嗪治疗的女性抑郁患者和接受舍曲林治疗的男性抑郁患者退出研究率更高;性别对丙米嗪的响应时间有影响,女性对丙米嗪的响应时间慢于男性;未绝经女性对舍曲林的响应率优于绝经女性,而绝经女性对两种药物的响应率大致相同。结论:男性和女性慢性抑郁患者对5-羟色胺再摄取抑制剂和三环类药物丙米嗪的响应率和耐受力有显著差异。未绝经女性对不同药物的响应率也不同。女性性激素加强了5-羟色胺再摄取抑制剂的响应率,而抑制了三环类药物的响应率。因此,抑郁患者选择治疗用药时需考虑性别和月经状态的影响。AIM： To examine the gender differ- ence on response to sertraline, a selective serotonin reuptake inhibitor, and to imipramine, a tricyclie antidepressant, for chronic depression. METHODS： A total of 235 male and 400 female outpatients with DSM-III-R chronic major depression or bipolar depression （i. e. , major depression superimposed on dysthymia） were randomly assigned to 12 weeks of double-blind treatment with sertraline or with imipramine after placebo washout. RESULTS： Women were significantly more likely to show a favorable response to sertraline than to imipramine, and men were significantly more likely to show a favorable response to imipramine than to sertraline. Gender and type of medication were also significantly related to dropout rates; women who were taking imipramine and men who were taking more likely to withdraw from the differences in time to response were sertraline were study. Gender seen with imi-pramine, with women responding significantly more slowly than men. Comparison of treatment response rates by menopausal status showed that premenopausal women responded significantly better to sertraline than to imipramine and that postmenopausal women had similar rates of response to the two medications. CONCLUSION： Men and women with chronic depression show differential responsivity and tolerability of SSRIs and tricyclic antidepressants. The differing response rates between the drug classes in women were observed primarily in pre-menopausal women. Thus, female sex hormones may enhance response to SSRIs or inhibit response to tricyclics. Both gender and menopausal status should be considered when choosing an appropriate antidepressant for a depressed patient

关 键 词：性别差异 慢性抑郁 舍曲林 丙米嗪 

分 类 号：R749.05[医药卫生—神经病学与精神病学]