Guy Chouinard , Lawrence Annable , Robert Langlois
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引用次数: 7
摘要
1.1. 安非他酮HCI (Wellbutrin®)是一种新型抗抑郁药，由于其对多巴胺再摄取的特异性抑制作用，已被报道具有较低的心血管毒性。为了研究安非他酮对心血管系统的影响，我们给5例在服用三环类抗抑郁药的同时表现出临床上明显的直立性低血压的抑郁症患者服用安非他酮两周。在使用安非他酮治疗之前进行一周的安慰剂洗脱期。在安非他酮治疗期间，没有患者表现出明显的直立性低血压:在完成研究的4例患者中，安非他酮治疗14天后仰卧和站立收缩压的平均差异(8.3±2.5 mm Hg)与安慰剂治疗7天后(8.3±3.2 mm Hg)相同，且显著(p <.001)低于三环类药物组(22.3±1.4 mm Hg)。因此，安非他酮似乎具有不会引起直立性低血压的优势，这在老年人和心血管疾病患者的治疗中具有潜在的重要意义。
Absence of orthostatic hypotension in depressed patients treated with bupropion
1.
1. Bupropion HCI (Wellbutrin®), a new antidepressant, has been reported to have low cardiovascular toxicity as a result of its specific inhibiting effect on the re-uptake of dopamine.
2.
2. In order to investigate its effect on the cardiovascular system we administered bupropion for two weeks to 5 depressed patients who manifested clinically significant orthostatic hypotension while being treated with tricyclic antidepressants. Treatment with bupropion was preceded by one week of placebo washout.
3.
3. Curing bupropion treatment none of the patients manifested significant orthostatic hypotension: in the 4 patients who completed the study the mean difference between supine and standing systolic blood pressure after 14 days of bupropion treatment (8.3 ± 2.5 mm Hg) was the same as after 7 days of placebo treatment (8.3 ± 3.2 mm Hg) and significantly (p < .001) lower than during treatment with tricyclics (22.3 ± 1.4 mm Hg).
4.
4. Thus, buproprion appears to have the advantage that it does not induce orthostatic hypotension, which is potentially important in the treatment of the elderly and those with cardiovascular disease.
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