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SELECTIVE SEROTONERGIC (SSRI) VERSUS NORADRENERGIC (SNRI) REUPTAKE INHIBITORS WITH AND WITHOUT ACETYLSALICYLIC ACID IN MAJOR DEPRESSIVE DISORDER
Nicolas Zdanowicz
; Université Catholique de Louvain, Psychosomatics Unit, Mont-GodinneUniversity Hospital, Yvoir, Belgium
Christine Reynaert
; Université Catholique de Louvain, Psychosomatics Unit, Mont-GodinneUniversity Hospital, Yvoir, Belgium
Denis Jacques
; Université Catholique de Louvain, Psychosomatics Unit, Mont-GodinneUniversity Hospital, Yvoir, Belgium
Brice Lepiece
; Université Catholique de Louvain, Psychosomatics Unit, Mont-GodinneUniversity Hospital, Yvoir, Belgium
Thomas Dubois
; Université Catholique de Louvain, Psychosomatics Unit, Mont-GodinneUniversity Hospital, Yvoir, Belgium
Sažetak
Background: Antidepressant medication efficacy remains a major research challenge. Here, we explored four questions:
whether noradrenergic antidepressants are more effective than serotonergic antidepressants; whether the addition of 100 mg
acetylsalicylic acid (ASA) changes antidepressant efficacy; whether the long-term efficacy differs depending on the antidepressant and the addition of ASA; and whether serum levels of brain-derived neurotrophic factor (BDNF) are clinically informative.
Subjects and methods: In a two-year study, forty people with major depressive disorder were randomly assigned to groups that
received an SSRI (escitalopram) or an SNRI (duloxetine), each group received concomitant ASA (100 mg) or a placebo.
Sociodemographic data were recorded and patients under went regular assessments with the Hamilton depression scale (HDS) and clinical global impression (CGI) scale. Serum levels of BDNF were measured four times per year.
Results: There was no significant difference in efficacy between the two antidepressants or between antidepressant treatment
with and without ASA. However, subgroup comparisons revealed that the duloxetine + ASA (DASA) subgroup showed a more rapid improvement in HDS score as early as 2 months (t=-3.114, p=0.01), in CGI score at 5 months (t=-2.119, p 0.05), and a better remission rate (2=6.296, p 0.012) than the escitalopram + placebo (EP) subgroup. Serum BDNF before treatment was also higher in the DASA subgroup than in the EP subgroup (t=3.713; p 0.002).
Conclusion: This suggest two hypotheses: either a noradrenergic agent combined with ASA is more effective in treating
depression than a serotonergic agent alone, or the level of serum BDNF before treatment is a precursor marker of the response to antidepressants. Further research is needed to test these hypotheses.
Ključne riječi
depression; efficacy; antidepressant drugs; BDNF; acetylsalicylic acid
Hrčak ID:
263827
URI
Datum izdavanja:
15.6.2017.
Posjeta: 271 *