选择性5-羟色胺再摄取抑制剂对抑郁症患者血清催乳素水平的影响

Effects of Selective Serotonin-Reuptake Inhibitors on Serum Prolactin Levels in Patients with Depression

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2023, 50(2)
作者
作者单位

上海市宝山区精神卫生中心 ;
上海交通大学医学院附属精神卫生中心 ;

摘要
目的:探讨SSRIs类药物舍曲林、艾司西酞普兰及帕罗西汀对抑郁症患者血清催乳素水平的影响,并分析影响催乳素水平变化的相关因素。 方法:180例抑郁症患者随机分为三组,分别予舍曲林、艾司西酞普兰和帕罗西汀治疗,观察12周。在基线和12周末测定血清催乳素,分析比较三组血清催乳素变化及高催乳素血症发生率,并将血清催乳素变化数值与药物剂量作相关性分析。 结果:治疗12周末,艾司西酞普兰组血清催乳素水平较基线处明显升高(P<0.05),舍曲林组及帕罗西汀组较基线处无明显变化(P>0.05),三组之间血清催乳素数水平无明显差异(P>0.05)。三种药物导致高催乳素血症的发生率分别为:舍曲林组7.02%,艾司西酞普兰组28.81%,帕罗西汀组10.34%。三组之间高催乳素血症发生率存在显著性差异(P<0.05),通过Bonferroni校正进行比较发现,艾司西酞普兰组引起高催乳素血症概率高于舍曲林组(P<0.05)和帕罗西汀组(P<0.05)。 结论:在临床中,SSRIs可引起高催乳素血症,尤其艾司西酞普兰在升高催乳素和导致高催乳素血症方面更常见。因此,在SSRIs抗抑郁药治疗中,医生应重视血清催乳素的监测。
Abstract
Objective: To explore the effects of SSRIs sertraline, escitalopram and paroxetine on serum prolactin level in patients with depression, and analyze the related factors influencing the change of prolactin level. Methods: A total of 180 patients with depression were randomly divided into three groups and treated with sertraline, escitalopram and paroxetine respectively for 12 weeks. Serum prolactin were measured at baseline and at the end of the 12th week. The changes of serum prolactin and the incidence of hyperprolactinemia were analyzed and compared among the three groups, and the correlation between the changes of serum prolactin and drug dose was analyzed. Results: After 12 weeks of treatment, serum prolactin levels in the escitalopram group were significantly higher than those at baseline (P<0.05), sertraline group and paroxetine group had no significant change from baseline (P>0.05), there was no significant difference in serum prolactin number among the three groups (P> 0.05). The incidence of hyperprolactinemia induced by the three drugs was 7.02% in sertraline group, 28.81% in escitalopram group and 10.34% in paroxetine group, respectively.There were significant differences in the incidence of hyperprolactinemia among the three groups (P<0.05), Bonferroni correction showed that the incidence of hyperprolactinemia in escitalopram group was higher than that in sertraline group (P<0.05) and paroxetine (P<0.05). Conclusion: In clinical practice, SSRIs can cause hyperprolactinemia, and escitalopram in particular is more common in increasing prolactin and leading to hyperprolactinemia. Therefore, doctors should pay attention to the monitoring of serum prolactin in the treatment of SSRIs antidepressants.
关键词
SSRIs;催乳素;高催乳素血症;抑郁症
KeyWord
SSRIs; Prolactin; Hyperprolactinemia; Depression
基金项目
页码 248-252
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董玲玲,张莉,褚庆文,刘翔,赵黎萍,朱宏伟*. 选择性5-羟色胺再摄取抑制剂对抑郁症患者血清催乳素水平的影响 [J]. 国际精神病学杂志. 2023; 50; (2). 248 - 252.

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