慢性耐药性抑郁症患者鼻内注射伊斯卡胺后认知症状的减轻:为期12周的病例系列。

IF 1.3 4区 医学 Q3 PSYCHIATRY
Maria Pepe, Giovanni Bartolucci, Ilaria Marcelli, Alessio Simonetti, Giovanni Camardese, Marco Di Nicola, Gabriele Sani
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引用次数: 0

摘要

背景:认知症状是抑郁症的一个核心特征,会影响患者功能的完全恢复,在耐药抑郁症(TRD)患者中尤为突出,特别是在严重的慢性病例中。鼻内注射(IN)艾司卡胺最近被批准用于治疗TRD,但其对认知症状的影响尚不明确。在本文中,我们描述了8名慢性TRD患者在接受埃斯氯胺酮鼻内注射治疗后的认知变化:8名门诊慢性TRD患者接受了3个月的艾司氯胺酮IN治疗,并在基线和治疗4、8、12周后使用蒙哥马利-奥斯伯格抑郁评定量表(MADRS)、数字符号替换测验(DSST)、寻迹测验-B(TMT-B)、抑郁患者缺陷问卷5项(PDQ-D5)、汉密尔顿焦虑评定量表(HARS)和临床整体印象量表(CGI)进行了评估:根据DSST、TMT-B和PDQ-D5评分,我们观察到在使用IN艾司卡胺治疗的头两个月内,认知症状有所减轻。这些改善是在患者达到临床反应(MADRS基线评分下降≥50%)之前观察到的,而且也早于HARS评分的下降:结论:慢性TRD重症患者经过3个月的治疗后,发现IN艾司卡胺产生了临床反应。有趣的是,在患者获得抗抑郁反应之前,就观察到了认知症状的改善。这些初步观察结果表明,艾司卡胺的抗抑郁特性具有额外的价值。将认知能力作为IN艾司卡胺治疗TRD的主要结果指标进行专门调查的临床研究是有必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reduction in Cognitive Symptoms Following Intranasal Esketamine Administration in Patients With Chronic Treatment-resistant Depression: A 12-Week Case Series.

Background: Cognitive symptoms are a core feature of depressive disorders, interfere with full functional recovery and are prominent in patients with treatment-resistant depression (TRD), particularly in severe chronic cases. Intranasal (IN) esketamine was recently approved for the treatment of TRD; however, its effects on cognitive symptoms are unclear. In this article, we describe cognitive changes in 8 patients with chronic TRD who were treated with IN administration of esketamine.

Methods: Eight outpatients with chronic TRD received IN esketamine over 3 months and were assessed at baseline and after 4, 8, and 12 weeks of treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS), the Digit Symbol Substitution Test (DSST), the Trail Making Test-B (TMT-B), the Patient Deficits Questionnaire for Depression 5-item (PDQ-D5), the Hamilton Anxiety Rating Scale (HARS), and the Clinical Global Impressions Scale (CGI).

Findings: We observed reductions in cognitive symptoms according to DSST, TMT-B, and PDQ-D5 scores within the first 2 months of treatment with IN esketamine. These improvements were observed before patients achieved clinical response (≥50% decrease in baseline MADRS scores), and they also occurred earlier than reductions in HARS scores.

Conclusions: A clinical response to IN esketamine was detected in severely ill patients with chronic TRD after 3 months of treatment. Interestingly, improvements on measures of cognitive symptoms were observed before patients achieved antidepressant response. These preliminary observations suggest an additional value to the antidepressant properties of IN esketamine. Clinical studies specifically investigating cognition as a primary outcome measure of IN esketamine in TRD are warranted.

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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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