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Titre du document / Document title

Addition of the α2-antagonist yohimbine to fluoxetine: Effects on rate of antidepressant response

Auteur(s) / Author(s)

SANACORA Gerard (1) ; BERMAN Robert M. (1) ; CAPPIELLO Angela (1) ; OREN Dan A. (1) ; KUGAYA Akira (1) ; NIANJUN LIU (1) ; GUEORGUIEVA Ralitza (2) ; FASULA Donna (1) ; CHARNEY Dennis S. (3) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Psychiatry, Yale University School of Medicine, New Haven, CT, ETATS-UNIS
(2) Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, ETATS-UNIS
(3) National Institute of Mental Health, Bethesda, MD, ETATS-UNIS

Résumé / Abstract

Electrophysiological studies suggest that α2-adrenoceptors profoundly affect monoaminergic neurotransmission by enhancing noradrenergic tone and serotonergic firing rates. Recent reports suggest that α2-antagonism may hasten and improve the response to antidepressant medications. To test this hypothesis, a randomized double-blind controlled trial was undertaken to determine if the combination of an α2-antagonist (yohimbine) with a selective serotonin reuptake agent (SSRI) (fluoxetine) results in more rapid onset of antidepressant action than an SSRI agent alone. In all, 50 subjects with a DSM-IV diagnosis of major depressive disorder confirmed by SCID interview were randomly assigned to receive either fluoxetine 20 mg plus placebo (F/P) or fluxetine 20 mg plus a titrated dose of yohimbine (F/Y). The yohimbine dose was titrated based on blood pressure changes over the treatment period, in a blind-preserving manner. Hamilton depression scale ratings (HDRS) and clinical global impression (CGI) ratings were obtained weekly over a period of 6 weeks. The rate of achieving categorical positive responses was significantly more rapid in the F/Y group compared to the F/P group using both the HDRS and the CGI scales as outcome measures in a survival analysis using a log-rank test (X2(I)=5.86, p=0.016 and X2(1)=5.29, p=0.021, respectively). At the last observed visit, 18 (69%) of the 26 F/Y subjects met the response criteria for CGI compared to 10 (42%) of 24 F/P subjects. Using the HDRS criteria, 17 (65%) of 26 F/Y subject vs 10 (42%) of 24 F/P subjects were responders. The addition of the x2-antagonist yohimbine to fluoxetine appears to hasten the antidepressant response. There is also a trend suggesting an increased percentage of responders to the combined treatment at the end of the 6-week trial.

Revue / Journal Title

Neuropsychopharmacology    ISSN  0893-133X   CODEN NEROEW 

Source / Source

2004, vol. 29, no6, pp. 1166-1171 [6 page(s) (article)] (28 ref.)

Langue / Language

Anglais

Editeur / Publisher

Nature Publishing Group, Basingstoke, ROYAUME-UNI  (1987) (Revue)

Mots-clés anglais / English Keywords

Neurotransmitter

;

Serotonin

;

Reuptake inhibitor

;

Psychotropic

;

α2-Adrenergic receptor

;

Mood disorder

;

Depression

;

Antidepressant agent

;

Fluoxetine

;

Yohimbine

;

Antagonist

;

Mots-clés français / French Keywords

Neurotransmetteur

;

Sérotonine

;

Inhibiteur recapture

;

Psychotrope

;

Récepteur α2-adrénergique

;

Trouble humeur

;

Etat dépressif

;

Antidépresseur

;

Fluoxétine

;

Yohimbine

;

Antagoniste

;

Mots-clés espagnols / Spanish Keywords

Neurotransmisor

;

Serotonina

;

Inhibidor recaptura

;

Psicotropo

;

Receptor α2-adrenérgico

;

Trastorno humor

;

Estado depresivo

;

Antidepresor

;

Fluoxetina

;

Antagonista

;

Mots-clés d'auteur / Author Keywords

major depression

;

mood disorders

;

treatment: α2-adrenergic receptor

;

Localisation / Location

INIST-CNRS, Cote INIST : 21601, 35400011200202.0140

Nº notice refdoc (ud4) : 15773765



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