阿托伐他汀对氟西汀治疗中、重度抑郁症的增效作用

Atorvastatin as an adjuvant therapy to fluoxetine in patients with moderate to severe major depression

目的评价阿托伐他汀对氟西汀治疗中、重度抑郁症的增效作用。方法中、重度抑郁症患者67例,分为阿托伐他汀和氟西汀联合治疗组(治疗组)34例、氟西汀单药治疗组(对照组)33例。疗程共6周,两组患者前2周口服氟西汀20 mg·d^(-1),随后4周口服氟西汀40 mg·d^(-1),治疗组同时服用阿托伐他汀20 mg·d^(-1)。评定治疗期间不同时点汉密顿抑郁量表(HAMD)评分,检测治疗前后天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平。结果治疗后,两组HAMD量表评分随时间减少(均P<0.01),治疗组的HAMD评分比对照组降低更明显(P<0.05,P<0.01)。治疗组TC、TG较对照组降低(均P<0.01),HDL-C、LDL-C、ALT、AST组间比较无显著差异(均P>0.05)。治疗期间两组均无严重不良事件发生。结论氟西汀联合阿托伐他汀治疗在6周内较氟西汀单药治疗能更有效减轻中、重度抑郁症的临床症状,阿托伐他汀可能是抑郁症的有效辅助治疗用药。

AIM To investigate the antidepressant effects of atorvastatin as an adjuvant therapy in patients with moderate to severe depression. METHODS Sixty-seven patients with moderate to severe major depression disorder were allocated to receive atorvastatin as an adjunct to fluoxetine（treatment group, n = 34）or fluoxetine treatment alone（control group, n = 33） for six weeks. All patients were prescribed fluoxetine 20 mg·d^（-1） for the first two weeks followed by fluoxetine 40 mg·d^（-1） for the subsequent four weeks, and the patients in the treatment group simultaneously received atorvastatin 20 mg·d^（-1） in the four weeks. The patients were evaluated with the Hamilton Depression Rating Scale（ HAMD） at baseline and weeks 2, 4 and 6. Probable clinical and laboratory adverse events were also monitored and compared between the two groups. RESULTS After the treatment, both groups showed a significant decrease in the HAMD scores（ P〈0.01）. However, the HAMD scores in the treatment group were lower than those of the control group（P〈0.05, P〈0.01）. The TC and TG levels of the treatment group were lower than those of the control group（P〈0.01）, and there were no significant difference between the groups in HDL-C, LDL-C, ALT and AST（ P〈0.05）. No serious adverse event was reported during this trial. CONCLUSION Fluoxetine combined with atorvastatin treatment is more effective than fluoxetine monotherapy in 6 weeks to alleviate the clinical symptoms of moderate to severe depression. These results suggest that atorvastatin may be effective as an adjuvant treatment for treating patients with depression.