背景:健康相关生活质量(HRQL)是重度抑郁症(MDD)患者的重要目标,但抗抑郁药是否能改善这些患者的HRQL尚不清楚.这里,我们描述了曲唑酮每日一次(TzOAD)和选择性5-羟色胺再摄取抑制剂(SSRI)治疗对MDD成人患者HRQL和功能的实际影响.
方法:这个为期8周的前瞻性,观察,开放标签,多中心研究是在中度或重度MDD的成人中进行的,其中TzOAD或SSRI被规定为单药治疗.主要结果是从基线到第8周,通过患者报告的生活质量享受和满意度问卷简表(Q-LES-Q-SF)评估生活享受和满意度。次要结果包括Q-LES-Q-SF从基线到第1周和第2周的变化;使用蒙哥马利奥斯贝格抑郁量表(MADRS)的抑郁症状严重程度和通过PROMISSF-SD8b问卷在第1、2和8周的睡眠障碍;以及通过Sheehan残疾量表(SDS)的整体功能,使用Snaith-Hamilton快乐量表(SHAPS)的享乐能力,在基线和第8周使用感知缺陷问卷(PDQ-5)和认知功能障碍。
结果:该研究包括208名患有MDD的成年人(平均[SD]年龄=50.2[14.3]岁;68.6%为女性;98.4%为白人)。从基线到第8周,两个治疗组的生活享受和满意度都得到了改善:SSRI组的Q-LES-Q-SF均值(SD)评分为27.5(20.4),TzOAD组为39.0(22.1)。抑郁症状和睡眠障碍也从基线降低到第8周:MADRS(SSRI,-15.7[8.3];TzOAD,-21.0[9.8]);PROMISSF-SD8b(SSRI,-9.9[12.6];TzOAD,-22.0[12.6])。Q-LES-Q-SF中的平均变化分数,MADRS,两组的PROMISSF-SD8b最早在第1周改善。在SDS上,从基线到第8周的平均得分也有所改善(SSRI,-9.2[7.4];TzOAD,-14.3[7.5]),SHAPS(SSRI,-6.6[4.3];TzOAD,-8.3[4.4]),和PDQ-5(SSRI,-5.8[4.5];TzOAD,-7.7[5.0])。
结论:在接受TzOAD或SSRIs的患有MDD的成年人中,整体和个体HQRL域迅速改善,同时改善抑郁症状,在TzOAD组中观察到稍大的改善。
BACKGROUND: Health-related quality of life (HRQL) is an important goal for patients with major depressive disorder (MDD), but whether antidepressants improve HRQL in these patients is unclear. Here, we describe the real-world effects of trazodone once-a-day (TzOAD) and selective serotonin reuptake inhibitor (SSRI) treatments on HRQL and functioning in adults with MDD.
METHODS: This 8-week prospective, observational, open-label, multicenter study was conducted in adults with moderate or severe MDD for whom TzOAD or SSRI were prescribed as monotherapy. The primary outcome was life enjoyment and satisfaction assessed via the patient-reported Quality-of-Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) from baseline to week 8. Secondary outcomes included change in Q-LES-Q-SF from baseline to weeks 1 and 2; severity of depressive symptoms using the Montgomery Åsberg Depression Rating Scale (MADRS) and sleep disturbance via the PROMIS SF-SD 8b questionnaire at weeks 1, 2, and 8; and overall functioning via the Sheehan Disability Scale (SDS), hedonic capacity using the Snaith-Hamilton Pleasure Scale (SHAPS), and cognitive dysfunction using the Perceived Deficits Questionnaire (PDQ-5) at baseline and week 8.
RESULTS: The study included 208 adults with MDD (mean [SD] age = 50.2 [14.3] years; 68.6% female; 98.4% White). Life enjoyment and satisfaction improved from baseline to week 8 for both treatment groups: Q-LES-Q-SF mean (SD) scores were 27.5 (20.4) for the SSRI group and 39.0 (22.1) for the TzOAD group. Depressive symptoms and sleep disturbances also reduced from baseline to week 8: MADRS (SSRI, -15.7 [8.3]; TzOAD, -21.0 [9.8]); PROMIS SF-SD 8b (SSRI, -9.9 [12.6]; TzOAD, -22.0 [12.6]). Mean change scores in Q-LES-Q-SF, MADRS, and PROMIS SF-SD 8b improved as early as week 1 in both groups. Mean scores also improved from baseline to week 8 on SDS (SSRI, -9.2 [7.4]; TzOAD, -14.3 [7.5]), SHAPS (SSRI, -6.6 [4.3]; TzOAD, -8.3 [4.4]), and PDQ-5 (SSRI, -5.8 [4.5]; TzOAD, -7.7 [5.0]).
CONCLUSIONS: In adults with MDD who received TzOAD or SSRIs, overall and individual HQRL domains improved rapidly and in parallel with improvements in depressive symptoms, with a slightly greater improvement observed in the TzOAD group.