阿立哌唑治疗抗抑郁药所致高催乳素血症的临床研究

Clinical study of aripiprazole in the treatment of antidepressant induced hyperprolactinemia

目的:探讨阿立哌唑治疗选择性5-羟色胺再摄取抑制剂(SSRIs)或5-羟色胺去甲肾上腺素再摄取抑制剂(SNRIs)类抗抑郁药所致高催乳素血症的疗效及安全性。方法:2020年1月至2021年12月宝山区精神卫生中心治疗的54例由SSRIs或SNRIs类抗抑郁药所致高催乳素血症患者随机分为两组,阿立哌唑组在原有抗抑郁药物基础上服用阿立哌唑片5 mg/d治疗,对照组只服用原有抗抑郁药物,无其他干预措施,观察12周。在基线和第4、8、12周末测定血清催乳素,予17项汉密尔顿抑郁量表(HAMD-17)评估抗抑郁疗效。分析比较两组血清催乳素变化及HAMD-17评分差异。结果:治疗第4、8、12周末,阿立哌唑组血清催乳素水平均低于对照组,两组间比较差异有统计学意义(P均<0.05)。阿立哌唑组治疗第4、8、12周末血清催乳素水平较基线处下降,差异均有统计学意义(P均<0.05),对照组治疗后各时点血清催乳素水平较基线处均无明显变化(P均>0.05)。治疗第12周末,阿立哌唑组HAMD-17评分低于对照组(P<0.05),药物不良反应发生率差异无统计学意义(P>0.05)。结论:阿立哌唑能有效降低SSRIs或SNRIs类抗抑郁药所致高催乳素血症患者的血清催乳素水平,同时对抗抑郁药治疗有一定增效作用。

Objective:To investigate the efficacy and safety of aripiprazole in the treatment of hyperprolactinemia caused by selective serotonin reuptake inhibitors(SSRIs)or serotonin and norepinephrine reuptake inhibitors(SNRIs)antidepressants.Method:A total of 54 patients with hyperprolactinemia caused by SSRIs or SNRIs from January to 2021 December 2020 in Baoshan District Mental Health Center were randomly divided into two groups.The experimental group was treated with aripiprazole tablets 5 mg/d on the basis of the original antidepressant drugs,while the control group was only treated with the original antidepressant drugs without other intervention measures for 12 weeks.Serum prolactin was measured at baseline and at the end of week 4,8,and 12,and treatment with 17-item Hamilton depression scale(HAMD-17)was used to evaluate antidepressant efficacy.Results:The serum prolactin level of the aripiprazole group was lower than that of the control group at the end of the 4th,8th and 12th week of treatment,and the difference was statistically significant(all P<0.05).The serum prolactin level of the aripiprazole group at the end of the 4th,8th and 12th week of treatment decreased compared with baseline,and the difference was statistically significant(all P<0.05),the serum prolactin level of the control group had no significant change at each time point after treatment compared with the baseline(all P>0.05).At the end of the 12th week of treatment,the HAMD-17 score of the aripiprazole group was lower than that of the control group(P<0.05),and there was no significant difference in the incidence of adverse drug reactions(P>0.05).Conclusion:Aripiprazole can effectively reduce the serum prolactin level in patients with hyperprolactinemia caused by SSRIs or SNRIs antidepressants,and has a certain synergistic effect in the treatment of antidepressants.