세로토닌 재흡수 억제제에 대한 아리피프라졸 및 부프로피온 부가요법의 우울증 세부증상에 대한 효과 비교 : 다기관, 개방표지, 무작위 연구
Comparative Effectiveness of Adjunctive Aripiprazole versus Bupropion Uses to Selective Serotonin Reuptake Inhibitor on the Specific Symptom of Depression : A post-hoc, Multi-Center, Open-Label, Randomized Study
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Objective : The purpose of this study was to examine the effects of adjunctive aripiprazole versus bupropion on specific symptoms of depression. Methods : Data were from 6-week, randomized, prospective, open-label multi-center study in 103 patients with major depressive disorders. Participants were randomized to receive aripiprazole (2.5-10 mg/ day) or bupropion (150-300 mg/day) for 6 weeks. Change in four subscales of the 17-item Hamilton Depression Rating Scale (HAM-D17) that capture core depression symptoms was determined, and change in individual HAM-D17 items was also assessed. Changes in three composite subscales-anxiety, insomnia, and drive were also examined. Results : Within-group change in the four core subscales was large [effect size (ES)=1.30-1.47] and it was similar to that in the HAM-D17 total score. Differences between aripiprazole and bupropion were significant for each of the four core subscales and the HAM-D17 total score favored aripiprazole (p<0.001). On three composite scales, both treatments caused substantial changes in anxiety (within-group ES=1.10 (aripiprazole) vs. 1.00 (bupropion)], insomnia (ES=0.75 vs 0.50), and drive (ES=1.17 vs 1.15). Conclusion : This results suggested that both aripiprazole and bupropion adjunctive therapies with selective serotonin reuptake inhibitors resulted in significant and clinically meaningful changes in core symptom subscales for depression. (Anxiety and Mood 2017;13(2):66-73)
Abstract
Objective : The purpose of this study was to examine the effects of adjunctive aripiprazole versus bupropion on specific symptoms of depression. Methods : Data were from 6-week, randomized, prospective, open-label multi-center study in 103 patients with major depressive disorders. Participants were randomized to receive aripiprazole (2.5-10 mg/ day) or bupropion (150-300 mg/day) for 6 weeks. Change in four subscales of the 17-item Hamilton Depression Rating Scale (HAM-D17) that capture core depression symptoms was determined, and change in individual HAM-D17 items was also assessed. Changes in three composite subscales-anxiety, insomnia, and drive were also examined. Results : Within-group change in the four core subscales was large [effect size (ES)=1.30-1.47] and it was similar to that in the HAM-D17 total score. Differences between aripiprazole and bupropion were significant for each of the four core subscales and the HAM-D17 total score favored aripiprazole (p<0.001). On three composite scales, both treatments caused substantial changes in anxiety (within-group ES=1.10 (aripiprazole) vs. 1.00 (bupropion)], insomnia (ES=0.75 vs 0.50), and drive (ES=1.17 vs 1.15). Conclusion : This results suggested that both aripiprazole and bupropion adjunctive therapies with selective serotonin reuptake inhibitors resulted in significant and clinically meaningful changes in core symptom subscales for depression. (Anxiety and Mood 2017;13(2):66-73)
참고문헌 (27)
- Kessler RC, "The epidemiology of major depressive disorder : results from the National Comorbidity Survey Replication(NCS-R)", JAMA, 289, pp.3095~3105 (2003)
- Association AP, "Practice guideline for the treatment of patients with major depressive disorder (revision)", Am J Psychiatry, 157, pp.1~45 (2000), American Psychiatric Association
- Murray CJ, "Alternative projections of mortality and disability by cause 1990-2020 : Global Burden of Disease Study", The Lancet, 349, pp.1498~1504 (1997)
- Fava M, "Background and rationale for the Sequenced Treatment Alternatives to Relieve Depression(STAR*D)study", Psychiatr Clin North Am, 26, pp.457~494 (2003)
- Trivedi MH, "Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice", Am J Psychiatry, 163, pp.28~40 (2006)
- Rush AJ, "Sequenced treatment alternatives to relieve depression(STAR*D) : rationale and design", Control Clin Trials, 25, pp.119~142 (2004)
- Mischoulon D, "Strategies for managing depression refractory to selective serotonin reuptake inhibitor treatment : a survey of clinicians", The Canadian Journal of Psychiatry, 45, pp.476~481 (2000)
- Nelson JC, "The use of antipsychotic drugs in the treatment of depression", Treating Resistant Depression, pp.131~146 (1987)
- Han C, "Second-generation antipsychotics in the treatment of major depressive disorder : current evidence", Expert Rev Neurother, 13, pp.851~870 (2013)
- Zhou X, "Comparative efficacy, acceptability, and tolerability of augmentation agents in treatment-resistant depression: systematic review and network meta-analysis", J Clin Psychiatry, 76, pp.e487~e498 (2015)
- Zisook S, "Use of bupropion in combination with serotonin reuptake inhibitors", Biol Psychiatry, 59, pp.203~210 (2006)
- Evans KR, "An item response analysis of the Hamilton Depression Rating Scale using shared data from two pharmaceutical companies", J Psychiatr Res, 38, pp.275~284 (2004)
- Gibbons RD, "Exactly what does the Hamilton depression rating scale measure?", J Psychiatr Res, 27, pp.259~273 (1993)
- Bech P, "Quantitative rating of depressive states", Acta Psychiatr Scand, 51, pp.161~170 (1975)
- Maier W, "Improving the assessment of severity of depressive states: a reduction of the Hamilton Depression Scale", Pharmacopsychiatry, 18, pp.114~115 (1985)
- Fava M, "Diagnosis and definition of treatment-resistant depression", Biol Psychiatry, 53, pp.649~659 (2003)
- Cheon EJ, "Comparison of the Efficacy and Safety of Aripiprazole Versus Bupropion Augmentation in Patients With Major Depressive Disorder Unresponsive to Selective Serotonin Reuptake Inhibitors: A Randomized, Prospective, Open-Label Study", J Clin Psychopharmacol, 37, pp.193~199 (2017)
- Cohen J., "Statistical power analysis for the behavioral sciences", pp.20~26 (1988), Lawrence Earlbaum Associates
- Nelson JC, "Effects of aripiprazole adjunctive to standard antidepressant treatment on the core symptoms of depression: a post-hoc, pooled analysis of two large, placebo-controlled studies", J Affect Disord, 120, pp.133~140 (2010)
- Nelson JC, "Assessment of outcome in depression", Journal of Psychopharmacology, 20, pp.47~53 (2006)
- Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
- 이중서, "한국판 Hamilton 우울증 평가 척도의 신뢰도, 타당도 연구", 신경정신의학, 44(4), pp.456~465 (2005), 대한신경정신의학회
- Nasr S, "Comparing outcomes of adjunctive treatment in depression: Aripiprazole versus Bupropion", J Affect Disord, 162, pp.50~54 (2014)
- Tadori Y, "Characterization of aripiprazole partial agonist activity at human dopamine D 3 receptors", Eur J Pharmacol, 597, pp.27~33 (2008)
- Ichikawa J, "5-HT2A and D2 receptor blockade increases cortical DA release via 5-HT1A receptor activation : a possible mechanism of atypical antipsychotic-induced cortical dopamine release", J Neurochem, 76, pp.1521~1531 (2001)
- Stahl SM, "A review of the neuropharmacology of bupropion, a dual norepinephrine and dopamine reuptake inhibitor", Prim Care Companion J Clin Psychiatry, 6, pp.159~166 (2004)
- Berman RM, "Aripiprazole augmentation in major depressive disorder:a double-blind, placebo-controlled study in patients with inadequate response to antidepressants", CNS Spectrums, 14, pp.197~206 (2009)
