Selective serotonin re-uptake inhibitor sertraline inhibits bone healing in a calvarial defect model

Bone wound healing is a highly dynamic and precisely controlled process through which damaged bone undergoes repair and complete regeneration. External factors can alter this process, leading to delayed or failed bone wound healing. The findings of recent studies suggest that the use of selective serotonin reuptake inhibitors(SSRIs) can reduce bone mass, precipitate osteoporotic fractures and increase the rate of dental implant failure. With 10% of Americans prescribed antidepressants, the potential of SSRIs to impair bone healing may adversely affect millions of patients’ ability to heal after sustaining trauma. Here, we investigate the effect of the SSRI sertraline on bone healing through pre-treatment with(10 mg·kg-1sertraline in drinking water, n = 26) or without(control, n = 30) SSRI followed by the creation of a 5-mm calvarial defect. Animals were randomized into three surgical groups:(a) empty/sham,(b) implanted with a DermaMatrix scaffold soak-loaded with sterile PBS or(c) DermaMatrix soak-loaded with542.5 ng BMP2. SSRI exposure continued until sacrifice in the exposed groups at 4 weeks after surgery. Sertraline exposure resulted in decreased bone healing with significant decreases in trabecular thickness, trabecular number and osteoclast dysfunction while significantly increasing mature collagen fiber formation. These findings indicate that sertraline exposure can impair bone wound healing through disruption of bone repair and regeneration while promoting or defaulting to scar formation within the defect site.

Single-run reversed-phase HPLC method for determining sertraline content,enantiomeric purity,and related substances in drug substance and finished product

A direct enantio-,diastereo-,and chemo-selective high-performance liquid chromatographic method was developed for determining the content,enantiomeric purity,and related substances of the chiral antidepressant drug sertraline HCl in a single chromatographic run.The separation was achieved on a chiral stationary phase based on amylose tris(3-chloro-5-methylphenylcarbamate)under reversed-phase conditions.The method was optimized by evaluating the influence of the temperature and mobile phase composition on the retention and selectivity.The application of the single-run approach allowed to baseline resolve all investigated species in less than 15 min,without using buffers or tandem-coupled columns.The chromatographic method was validated according to the guidelines of the Official Medicines Control Laboratory and applied to control the content of sertraline HCl and related chiral substances in a generic antidepressant formulation.

Comparative study of on-demand and daily use of sertraline in treatment of premature ejaculation:A randomized clinical trial

Objective:The intravaginal ejaculatory latency time(IELT)may increase less in on-demand compared to daily intake,but may fulfill a suitable treatment for specific patients.We decided to compare the efficacy and safety of on-demand and daily use of sertraline in order to find the most effective and least complicated method in treatment of premature ejaculation(PE).Methods:This study was parallel or concurrent control randomized clinical trial.Two hundred and forty patients with PE diagnosed by urologist in the two groups of 120 from July 2017 to February 2019 enrolled in the study.In the first group,it is prescribed 50 mg sertraline each 12 h daily and the second group received 50 mg 4 h before coitus for 4 and 8 weeks.The IELT before treatment and during all coitus after treatment were recorded by the patient’s wife with a stopwatch.Results:Mean IELT before,4 and 8 weeks after treatment in two groups were:On-demand group 101.62±65.44 s,208.75±128.02 s and 265.87±145.70 s;daily use group 102.50-81.22 s,276.87±181.08 s and 353.75±176.45 s,respectively.The ejaculation time increased significantly in both groups(p<0.05).However,increase in ejaculation time in daily use group was significantly higher than the on-demand group in 4 weeks(p=0.036),especially in 8 weeks(p=0.009).The percent of side effects in daily use group(26.7%)was higher than on-demand group(20%)(p<0.05).Drowsiness,diarrhea and vertigo were significantly higher in the daily use than on-demand(p<0.05).Conclusions:On-demand and daily use of sertraline are effective and usually have no serious complications,but the on-demand method is considerably more tolerable.In patients who did not tolerate to daily use of this drug,on-demand could be used as a salvage therapy.

Sertraline Induced Acute Hepatitis: A Case Report

Depression is a common disorder amongst the general population and frequently encountered by most physicians. Selective Serotonin Re-Uptake Inhibitors (SSRI’s) have become the most commonly prescribed antidepressants due to their superiority compared with other antidepressants in the treatment of acute major depression. Although exceedingly rare, hepatotoxicity resulting from sertraline use has been previously reported. In these case reports, the liver injury pattern was predominately hepatocellular. Unlike previous cases, we report the case of a patient presenting with markedly elevated cholestatic enzymes and painless jaundice while taking sertraline for treatment of depression.

Effects of Sertraline on Sperm Motility, Number and Viability and Its Relation to Blood Levels of Testosterone, FSH and LH in Adult Male Mice

The aim of this study was to investigate the effects of Sertraline on gonad-pituitary cycle (Testosterone, FSH and LH) and reproductive cells in adult male Balb/C mice. Adult male Balb/C mice were divided into the following 5 groups: control group with no treatment, sham group which received solvent, and the experimental groups which received one dose of Sertraline (0.0178 mg/kg) in the first group, two doses of Sertraline (0.0356 mg/kg) in the second group, and three doses of Sertraline (0.0534 mg/kg) in the third group. Mice were anaesthetized after 7 weeks. Serum samples were collected and Testosterone, FSH and LH levels of serum were assayed. Vase deferans were analyzed for motility, number and viability of sperms. The results of this study showed that the viability, count and motility of sperms were decreased. Testosterone level of blood was also decreased while FSH was increased. There was no significant change in LH level. It is suggested that Sertraline at higher dose decreases sperm production and has the potential to affect adversely fertility in male mice.

Treatment of functional dyspepsia with sertraline:A double-blind randomized placebo-controlled pilot study

AIM:To evaluate sertraline,a selective serotonin reuptake inhibitor in the treatment of patients with functional dyspepsia.METHODS:Consecutive tertiary hospital patients with a clinical diagnosis of functional dyspepsia(FD) according to the Rome Ⅱ criteria with a Hong Kong dyspepsia index(HKDI) of greater than 16 were recruited.Patients commenced enrolment prior to the inception of the Rome Ⅲ criteria for functional dyspepsia.All patients were ethnic Chinese,had a normal upper endoscopy and were Helicobacter pylori negative prior to enrolment.Study patients were randomized to receive sertraline 50 mg or placebo daily for 8 wk.HKDI symptom scores,quality of life,hospital anxiety and depression(HAD) scale and global symptom relief were evaluated before,during and after treatment.Adverse effects were monitored during and after treatment.RESULTS:A total of 193 patients were randomized in the intention to treat(ITT),and 150 patients were included in the per protocol(PP) analysis.In both the ITT and PP,there was no difference in the primary outcome of global dyspepsia symptoms between the sertraline and placebo groups at week 8.In the ITT analysis,98 and 95 patients were randomized to the sertraline and placebo groups respectively.A total of 43 patients withdrew from the study(22.3%) by week 8,with 23 of the 24 drop-outs in the sertraline group occurring prior to week 4(95.8%).In contrast,in the placebo arm,11 of 19 patients dropped out by week 4(57.9%).Utilizing the last response carried forward to account for the drop-outs,there were no differences between the sertraline and placebo groups at baseline in terms of the HKDI,HKDI 26.08 ± 6.19 vs 26.70 ± 5.89,P = 0.433;and at week 8,HKDI 22.41 ± 6.36 vs 23.25 ± 7.30,P = 0.352 respectively.In the PP analysis,74 and 76 patients were randomized to the sertraline and placebo groups respectively.At baseline,there were no statistically significant differences between the sertraline and placebo groups,HKDI 25.83 ± 6.313 vs 27.19 ± 5.929 respectively,P = 0.233;however by week 8,patients in the sertraline group demonstrated a statistically significant difference in their Hong Kong Dyspepsia Index compared to placebo,HKDI 20.53 ± 6.917 vs 23.34 ± 7.199,P = 0.02,respectively).There was also no statistically significant difference in overall quality of life measures or the HAD scale related to treatment in either the ITT or PP analysis at week 8.CONCLUSION:This pilot study,the first to examine sertraline,a selective serotonin reuptake inhibitor,for the management of FD,did not find that it was superior to placebo.

舍曲林与认知行为疗法联合治疗青少年抑郁症的效果

目的 探讨分析在青少年抑郁症中联合应用舍曲林与认知行为疗法干预对临床疗效的影响。方法 抽取2020年7月至2023年3月泉州市第三医院接诊的青少年抑郁症患者96例为研究对象,根据就诊挂号顺序将患者分为对照组(单数)和观察组(双数),各48例,给予对照组单独舍曲林干预,给予观察组舍曲林与认知行为疗法联合干预。对两组干预前后的汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、自杀态度量表(QSA)评分进行比较,同时统计两组临床治疗总有效率。结果 干预4周、8周后,两组HAMD、HAMA评分均较干预前降低,且观察组降低幅度比对照组大(P <0.05);干预8周后,两组QSA各维度(对自杀行为性质认知、对自杀者的态度、对自杀家属的态度、对安乐死的态度)评分均较干预前升高,观察组升高幅度比对照组大(P <0.05);观察组临床治疗总有效率95.83%高于对照组81.25%(χ^(2)=5.031,P=5.031)。结论 青少年抑郁症患者中联合应用舍曲林与认知行为疗法干预能够获得理想的干预效果,可减轻其抑郁、焦虑症状程度,扭转其自杀意识。

舍曲林联合理性情绪疗法对首发青少年抑郁症患者的临床观察

目的:探讨舍曲林联合理性情绪疗法对首发青少年抑郁症患者的临床疗效和安全性。方法:纳入2020年4月至2022年4月于武汉市第一医院神经内科睡眠与心理门诊就诊的首发青少年抑郁症患者90例,采用随机数字表法分为两组,研究组和对照组各45例,研究组采用舍曲林联合理性情绪疗法,对照组给予舍曲林治疗。于治疗前及治疗第4、8周末,采用汉密尔顿抑郁量表(HAMD)、症状自评量表(SCL-90)评估情绪状态,采用治疗副反应量表(TESS)评估药物的安全性。结果:治疗4周、治疗8周,两组的HAMD总分及焦虑/躯体化、认知障碍、阻滞、全身症状等因子分均较治疗前下降(P均<0.05),且研究组的HAMD总分、认知障碍、阻滞均低于对照组(P均<0.05),重复测量方差分析显示治疗8周的HAMD总粗分及认知障碍、睡眠障碍等因子分均低于治疗4周(P均<0.05)。研究组治疗4周、治疗8周的SCL-90总分均低于治疗前,且研究组低于对照组(P<0.05)。治疗后两组TESS评分对比差异无统计学意义(P>0.05),不良反应主要为恶心、头晕、嗜睡。结论:舍曲林联合理性情绪疗法可有效改善青少年抑郁症状,优于单一药物治疗,且安全性理想,值得临床推广应用。

固定化c-ω-转氨酶催化合成(4S)-四氢萘酮

以T4噬菌体衣壳为载体,探索了海绵假弧菌-ω-转氨酶(P-ω-TA)的自组装固定化,以将P-ω-TA与T4噬菌体非必需小外壳蛋白(Soc)融合的方式实现了P-ω-TA在T4噬菌体衣壳上的亲和固定及较高的位点结合数。对固定化P-ω-TA的适应性、回收性能、(S)-型异构体选择性拆分及(1S,4S)-去甲基舍曲林的催化能力进行了测试。结果表明,固定化的P-ω-TA保持了完整的活性及适应性,可通过离心操作轻松地回收,并进行重复使用。在5次回收和重复使用过程中,每次酶活回收率均>91%,经5次催化,最终酶活保持率约为84%。固定化P-ω-TA保持了在底物手性中心处的(S)-型异构体选择性拆分以及对(1S,4S)-去甲基舍曲林的催化能力。

Sertraline-induced reproductive toxicity in male rats： evaluation of possible underlying mechanisms

This study was conducted to clarify the toxic effects of sertraline （SRT） on the reproductive system of male rats and to elucidate the underlying mechanisms. Rats were treated orally with SRT at doses of 5, 10, and 20 mg kg-1 for 28 consecutive days. At the end of the treatment period, sperm concentration, sperm motility, and sperm morphology were investigated by computer-assisted sperm analysis system whereas sperm DNA damage was detected by comet assay. The oxidative status of the testes was investigated, and a histopathological examination was conducted. Serum testosterone, follicle-stimulating hormone （FSH）, and luteinizing hormone （LH） levels were measured to determine the effects of SRT on the spermatogenesis process. One-way ANOVA, post-hoc Dunnett＇s T3 test for the sperm comet assay, and post-hoc Tukey＇s test for the others were performed for statistical analysis. The results showed that SRT caused an increase in sperm DNA damage and induced histopathological lesions in all groups treated with SRT. There was abnormal sperm morphology and increased malondialdehyde （MDA） in the 10 mg kg-1 treatment group. More dramatic changes were observed in the 20 mg kg-1 treatment group. Decreased sperm count was accompanied by a significant increase in abnormal sperm morphology, DNA damage, and degeneration in cellular-tubular structures. Serum LH and testosterone levels were elevated in the 20 mg kg-~ treatment group. Decreased glutathione （GSH） and increased MDA were signs of enhanced oxidative stress （OS）. In conclusion, SRT induced testicular toxicity in a dose-dependent manner and OS is suggested as a crucial mechanism.

盐酸舍曲林和草酸艾司西酞普兰用于抑郁症治疗的安全性比较:基于FAERS数据库不良事件分析

目的通过对美国FDA不良事件报告系统(FAERS)数据库的数据挖掘,探讨盐酸舍曲林和草酸艾司西酞普兰的安全性差异。方法采用报告比值比(ROR)法和比例报告比值比(PRR)法,对FAERS数据库中2011年第1季度至2023年第2季度报告的盐酸舍曲林和草酸艾司西酞普兰的不良事件进行数据挖掘。结果女性发生不良事件的比例高于男性(男女比例约为1∶2)。盐酸舍曲林和草酸艾司西酞普兰均在18~64岁年龄组中的报告频率更高。累及系统器官分布方面,盐酸舍曲林组和草酸艾司西酞普兰组相似,但在生殖系统及乳腺疾病毒性方面存在差异,盐酸舍曲林的生殖器感觉减退信号更多,草酸艾司西酞普兰则更影响溢乳。在检测到的前10个报告信号中,药物相互作用、药物无效、恶心、头晕、头痛、焦虑的信号在盐酸舍曲林和草酸艾司西酞普兰中均有生成,盐酸舍曲林组中发生自杀意念、药物相互作用、震颤、焦虑等不良事件的可能性更大,草酸艾司西酞普兰组中更可能发生产品替换问题、妊娠期胎儿暴露、药物相互作用,提示二者的高频不良事件之间存在差异。结论盐酸舍曲林和草酸艾司西酞普兰具有相同的部分高频不良事件、相似的全身器官分布和相似的总体安全性,但在精神病类和各类检查方面存在差异,草酸艾司西酞普兰出现心电图QT间期延长不良信号强,用药后应定期复查心电图,减少晕厥、心脏骤停或死亡的风险。盐酸舍曲林出现自杀想法的信号强度高,应重视患者在治疗期间持续出现自杀想法。

度洛西汀与舍曲林治疗老年抑郁症患者的临床效果及安全性比较

目的对比研究度洛西汀与舍曲林治疗老年抑郁症患者的临床效果及安全性。方法将2022年10月至2023年6月于上杭县医院收治的老年抑郁症患者中抽出70例,其中35例纳入对照组选择舍曲林治疗,35例纳入观察组选择度洛西汀治疗,比较两组的治疗效果及不良反应发生情况。结果观察组治疗后的睡眠障碍、焦虑/躯体化、认知障碍等症状评分和不良反应发生率均低于对照组(均P<0.05);观察组治疗总有效率高于对照组(P<0.05)。结论与舍曲林相比较,采用度洛西汀治疗老年抑郁症患者的整体疗效更显著,有助于改善患者临床症状和提高治疗效果,且药物所致不良反应更低。

舍曲林片联合相对卧床式森田疗法在伴非自杀性自伤青少年抑郁症中的应用效果

目的探讨舍曲林片联合相对卧床式森田疗法在伴非自杀性自伤(NSSI)青少年抑郁症中的应用效果。方法选取2021年1月至2022年12月赣州市第三人民医院精神科收治的60例伴NSSI的青少年抑郁症患者作为研究对象,按照随机数字表法将其分为对照组(30例)和研究组(30例)。对照组患者采用单一的舍曲林片治疗,研究组患者采用舍曲林片与相对卧床式森田疗法联合治疗。比较两组治疗前及治疗2、4、6周后的渥太华自伤量表(OSI)、汉密尔顿抑郁量表(HAMD)和生活质量简表(SF-36)评分。结果研究组治疗2、4、6周后的OSI评分均低于对照组,差异有统计学意义(P<0.05);研究组治疗2、4、6周后的HAMD评分均低于对照组,差异有统计学意义(P<0.05);研究组治疗6周后的SF-36评分高于对照组,差异有统计学意义(P<0.05)。结论伴NSSI青少年抑郁症患者采用舍曲林片与相对卧床式森田疗法联合治疗的效果较显著,不仅能有效减少其自伤行为的发生,还能减轻其抑郁症状,提高其生活质量,临床可进一步推广。

舍曲林联合右佐匹克隆治疗脑卒中后抑郁的临床效果及对睡眠质量的影响

目的分析脑卒中后抑郁患者以舍曲林联合右佐匹克隆方式展开临床治疗的效果,并探究对患者睡眠质量的影响。方法选取2020年10月—2022年12月赤峰市医院神经内科收治的72例脑卒中后抑郁患者作为研究对象,以单盲分组方法实施组别划分,分为参照组(n=36)与研究组(n=36),参照组以舍曲林为患者实施药物治疗,研究组以舍曲林联合右佐匹克隆方式为患者实施药物治疗,对两组患者临床治疗效果进行比较。结果研究组的总有效率(94.44%)高于参照组,差异有统计学意义(χ^(2)=6.400,P<0.05);治疗后,研究组的血清中枢神经特异蛋白显著低于参照组,且脑源性神经营养因子明显高于参照组,差异有统计学意义(P均<0.05);治疗后,研究组的神经功能缺损评估量表评分、匹兹堡睡眠质量指数量表评分、汉密顿抑郁量表评分、汉密尔顿焦虑量表评分均低于参照组,差异有统计学意义(P均<0.05);研究组的超敏C反应蛋白低于参照组,且血管内皮生长因子高于参照组,差异有统计学意义(P均<0.05)。结论脑卒中后抑郁患者以舍曲林联合右佐匹克隆方式实施药物治疗,可改善患者神经功能与睡眠质量,有助于患者临床治疗效果的提升,对缓解患者抑郁症状具有积极意义。

Evaluation on monoamine neurotransmitters changes in depression rats given with sertraline, meloxicam or/and caffeic acid

Inflammation drives the development of depression and may affect neurotransmitters and thus neurocircuits increase the risk of depression.To investigate the influence of inhibition of inflammatory pathways on the biogenic amine neurotransmitters metabolism in depressive rats,sertraline,and meloxicam,the inhibitors of arachidonic acid-cyclooxygenase-2/lipoxygenase(AA-COX-2/5-LO)pathways,were given to depressive rats.After the development of depression model by chronic unpredictable mild stress(CUMS)for 6 weeks,Successful modeling rats were selected and randomly divided into CUMS group and medication administration group.After given medicine,The biogenic amine neurotransmitters in rat cortex and hippocampus were measured by high-performance liquid chromatography equipped with an electrochemical detector(HPLC-ECD).Compared with the normal group,the concentration of norepinephrine(NE)significantly decreased and the concentrations of Tyrosine(Tyr),Tryptophan(Trp),3,4-dihydroxyphenyl acetic acid(DOPAC),3-methoxy-4-hydroxyphenylglycol(MHPG),homovanillic acid(HVA)and 5-hydroxyindoleacetic acid(5-HIAA)significantly increased in the CUMS group.Sertraline significantly inhibited the elevation of 5-HIAA.Meloxicam inhibited the decrease of NE level in CUMS-induced rat and the increase of Trp,MHPG,and 5-HIAA level in a dose-dependent manner.Caffeic acid inhibited the decrease of NE and the increase of Trp and MHPG in a dose-dependent manner.The inhibition of AA-COX-2/5-LO pathways can improve the behaviors of depression rats and suppress CUMSinduced changes in biogenic amines.Compared with the single-dose lipoxygenase(5-LO)or Cyclooxygenase-2(COX-2)inhibitor,the combination treatment with meloxicam 1 mg/kg and caffeic acid 10 mg/kg have no significant improvement in CUMS-induced depression behavior and the level of cortical monoamine neurotransmitters and their metabolites.

五行针灸联合舍曲林治疗抑郁症临床研究

目的 观察盐酸舍曲林片联合五行针灸治疗抑郁症的有效性与安全性。方法 纳入60例抑郁症患者,随机分为治疗组和对照组各30例。2组均口服盐酸舍曲林片,治疗组加用五行针灸治疗,共治疗70 d。分别在治疗前后应用汉密尔顿抑郁量表(HAMD)、比较5-羟色胺水平来评估受试者的抑郁状态。结果 治疗后,2组的HAMD评分、5-羟色胺水平均较治疗前明显改善(P<0.05),且治疗组优于对照组(P<0.05)。结论 舍曲林联合五行针灸治疗能够有效的降低抑郁症患者量表评分,提高5-羟色胺水平,治疗效果显著。

舍曲林联合右佐匹克隆治疗老年抑郁症伴失眠的效果观察

目的观察舍曲林联合右佐匹克隆治疗老年抑郁症伴失眠的临床效果。方法76例老年抑郁症伴失眠患者根据随机数字表法分为观察组(40例)和对照组(36例)。对照组单独给予药舍曲林片治疗,观察组在对照组基础上加服右佐匹克隆片治疗。记录两组患者每日有效剂量、起效时间,比较两组患者临床疗效、不良反应发生情况以及治疗前后汉密顿抑郁量表(HAMD)评分、睡眠效果。结果观察组中有2例患者1周后脱落,对照组有1例1周后脱落,其余患者完成6周疗程,对剩余73例患者资料完整进行分析。观察组舍曲林、右佐匹克隆分别为平均每日有效剂量分别为(61.58±18.08)、(1.52±0.72)mg,平均起效时间为1.5周;对照组舍曲林平均每日有效剂量为(64.64±19.52)mg,平均起效时间为2周。两组舍曲林平均每日有效剂量比较差异无统计学意义(P>0.05)。对照组痊愈11例,显效11例,有效4例,无效9例,总有效率74.3%;观察组痊愈20例,显效14例,有效2例,无效2例,总有效率94.7%。观察组治疗总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗1、2、4、6周后,两组评分均低于治疗前,且治疗4、6周后,观察组HAMD评分分别为(14.00±3.87)、(9.71±3.18)分,均明显低于对照组的(16.40±2.87)、(13.11±2.47)分,差异有统计学意义(P<0.05)。治疗6周后,观察组患者匹兹堡睡眠质量指数量表(PSQI)评分(8.28±2.56)分低于对照组的(11.35±2.17)分,差异有统计学意义(P<0.05)。治疗过程中发生头昏、嗜睡、厌食、恶心、口干、腹泻、失眠、心动过速,观察组不良反应发生率21.1%(8/38)与治疗组的17.1%(6/35)比较,差异无统计学意义(P>0.05)。以上经对症处理,均很快缓解,血常规、肝功能、肾功能等实验室检查正常。结论舍曲林联合右佐匹克隆在老年抑郁症伴失眠的治疗中,服用方便,耐受性好,无药物依赖性,效果显著,安全性高,故值得临床推广。

重复经颅磁刺激联合舍曲林对改善抑郁障碍认知功能的研究

目的:探讨重复经颅磁刺激(rTMS)联合舍曲林对抑郁障碍疗效和认知功能的改善程度。方法:纳入80例抑郁障碍患者,在均给予舍曲林(有效血药浓度范围10.0~150.0 ng/ml)抗抑郁治疗的基础上随机分为两组,研究组联合低频rTMS(右背外侧前额叶、刺激强度80%~100%、刺激频率1 Hz、脉冲数2 000次以上)治疗,对照组给予假刺激治疗,连续治疗4周。通过比较24项汉密尔顿抑郁量表(HAMD-24)、认知功能缺陷自评问卷(PDQ-D)、数字广度测验(DST)、临床总体印象量表(CGI)、治疗中出现的症状量表(TESS)于治疗前后的评分结果以评估治疗效果及安全性。结果:在治疗后第2、4周末,两组治疗后HAMD-24和PDQ-D评分较治疗前均显著降低(P均<0.05)。而DST评分和CGI评分较治疗前显著提高(P均<0.05)。研究组比对照组占明显改善优势。结论:rTMS联合舍曲林对抑郁障碍的疗效较单纯性使用抗抑郁药更为显效,且起效时间相对加快,可有效、安全地改善抑郁障碍患者的临床症状及认知功能。

盐酸安非他酮联合盐酸舍曲林对青少年抑郁症疲劳感的治疗效果

目的:探讨盐酸安非他酮联合盐酸舍曲林对青少年抑郁症疲劳感的治疗效果。方法:于2021年6月至2023年5月收集100例青少年抑郁症患者进行研究,随机分为研究组与对照组各50例,两组患者均采用盐酸舍曲林治疗,研究组在盐酸舍曲林基础上联合盐酸安非他酮治疗,治疗前及治疗2周、4周后采用患者健康问卷抑郁症状群量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)、疲劳量表(FS-14)进行心理评估,明确治疗效果。结果:①两组患者治疗前PHQ-9、GAD-7评分比较差异均无统计学意义(P>0.05),治疗2周、4周后研究组的PHQ-9评分比对照组降低的更明显,重复测量方差分析显示治疗后两组PHQ-9评分的时间效应、组间效应及交互效应均显著(F_(时间)=447.956,F_(组间)=4.305,F_(交互)=30.358;P<0.05);两组患者GAD-7评分的在治疗2周及4周后均明显降低,重复测量方差分析显示治疗后两组GAD-7评分的时间效应显著(F_(时间)=229.364,P<0.05),组间效应及交互效应无差异(P>0.05);②两组患者治疗前FS-14评分比较差异均无统计学意义(P>0.05),治疗2周、4周后研究组的FS-14评分比对照组降低的更明显,重复测量方差分析显示治疗后两组FS-14评分的时间效应、组间效应及交互效应均显著(F_(时间)=784.133,F_(组间)=149.191,F_(交互)=66.486;P<0.01);③两组患者治疗前每日平均卧床时间比较差异无统计学意义(P>0.05);治疗2周后研究组每日平均卧床时间明显短于对照组,两组比较差异有显著的统计学意义(P<0.01);治疗4周后两组比较差异无统计学意义(P>0.05);重复测量方差分析显示治疗后两组每日平均卧床时间的时间效应、组间效应及交互效应均显著(F_(时间)=319.977,F_(组间)=5.965,F_(交互)=6.929;P<0.05);④研究组的坐立不安、激越的发生率明显高于对照组,两组比较差异有统计学意义(χ^(2)=6.462,4.914;P<0.05)。结论:盐酸安非他酮联合盐酸舍曲林可以改善青少年抑郁症抑郁情绪及疲乏感,尽早缩短卧床时间,有利于疾病治疗,但需监测坐立不安、激越的不良反应发生率。