Mirtazapine in Comorbid Major Depression and Alcohol Use Disorder: A Long-Term Follow-Up Study.

Jack R Cornelius, Antoine B Douaihy, Duncan B Clark, Dennis C Daley, Tammy A Chung, Maribeth A Wesesky, D Scott Wood, Ihsan Salloum
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引用次数: 11

Abstract

Background/objective: To date, pharmacotherapy trials of depressed alcoholics (MDD/AUD) have focused on SSRI medications, with disappointing results, so effective treatments for that comorbid population are lacking. Mirtazapine is an FDA-approved medication for treating MDD with a unique pharmacological profile whose efficacy may exceed that of SSRIs. Results from our recent open label study suggest robust acute phase efficacy for mirtazapine for decreasing both the depression and the drinking of that population. However, to date, no studies have evaluated the longer-term efficacy of mirtazapine in that population. We now report findings from a first long-term (two-year) naturalistic follow-up evaluation involving subjects from the acute phase trial. We hypothesized that the improvements would persist at follow-up.

Methods: An eight-week open label study of mirtazapine and motivation therapy was conducted involving persons 18 to 55 years of age with DSM-IV diagnoses of comorbid MDD/AD. Two years after entry into the acute phase study, a long-term evaluation was conducted using the same instruments that had been used at baseline to assess whether the improvements seen during the acute phase trial had persisted.

Results: Ten of the twelve patients who entered the acute phase study participated in the follow-up study. The large magnitude improvements (p<.01) in depressive symptoms (BDI), drinking (TLFB), and sleep disturbance (HDRS) persisted at the follow-up evaluation. Two of the subjects demonstrated MDD on structured interview at follow-up, while all ten had demonstrated MDD at baseline. Six of the ten used antidepressants during the follow-up period. At baseline, three were employed, while at follow-up seven were employed.

Conclusions: These findings suggest long-term efficacy for mirtazapine for decreasing the drinking and depression of depressed alcoholics. Double-blind, placebo-controlled studies are warranted to clarify the efficacy of mirtazapine in depressed alcoholics.

米氮平治疗重度抑郁症和酒精使用障碍的长期随访研究
背景/目的:迄今为止,抑郁症酗酒者(MDD/AUD)的药物治疗试验主要集中在SSRI药物上,结果令人失望,因此缺乏针对该合并症人群的有效治疗方法。米氮平是fda批准的治疗重度抑郁症的药物,具有独特的药理学特征,其疗效可能超过SSRIs。我们最近的开放标签研究结果表明,米氮平在急性期对减少抑郁和饮酒都有很强的疗效。然而,到目前为止,还没有研究评估米氮平在该人群中的长期疗效。我们现在报告第一个长期(两年)自然随访评估的结果,涉及急性期试验的受试者。我们假设这种改善会在随访中持续存在。方法:一项为期8周的米氮平和动机治疗的开放标签研究,涉及18至55岁的DSM-IV诊断为MDD/AD合并症的患者。进入急性期研究两年后,使用基线时使用的相同工具进行长期评估,以评估急性期试验期间所见的改善是否持续存在。结果:进入急性期研究的12例患者中有10例参加了随访研究。结论:这些发现表明米氮平对减少抑郁性酗酒者的饮酒和抑郁具有长期疗效。双盲、安慰剂对照研究证实米氮平对抑郁症酗酒者的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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