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

다국어 초록 (Multilingual 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.

참고문헌 (Reference)

1 이중서, "한국판 Hamilton 우울증 평가 척도의 신뢰도, 타당도 연구" 대한신경정신의학회 44 (44): 456-465, 2005

2 Zisook S, "Use of bupropion in combination with serotonin reuptake inhibitors" 59 : 203-210, 2006

3 Nelson JC, "The use of antipsychotic drugs in the treatment of depression" 131-146, 1987

4 Kessler RC, "The epidemiology of major depressive disorder : results from the National Comorbidity Survey Replication(NCS-R)" 289 : 3095-3105, 2003

5 Mischoulon D, "Strategies for managing depression refractory to selective serotonin reuptake inhibitor treatment : a survey of clinicians" 45 : 476-481, 2000

6 Cohen J., "Statistical power analysis for the behavioral sciences" Lawrence Earlbaum Associates 20-26, 1988

7 Rush AJ, "Sequenced treatment alternatives to relieve depression(STAR*D) : rationale and design" 25 : 119-142, 2004

8 Han C, "Second-generation antipsychotics in the treatment of major depressive disorder : current evidence" 13 : 851-870, 2013

9 Bech P, "Quantitative rating of depressive states" 51 : 161-170, 1975

10 Association AP, "Practice guideline for the treatment of patients with major depressive disorder (revision)" American Psychiatric Association 157 : 1-45, 2000

11 Maier W, "Improving the assessment of severity of depressive states: a reduction of the Hamilton Depression Scale" 18 : 114-115, 1985

12 Gibbons RD, "Exactly what does the Hamilton depression rating scale measure?" 27 : 259-273, 1993

13 Trivedi MH, "Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice" 163 : 28-40, 2006

14 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" 120 : 133-140, 2010

15 Fava M, "Diagnosis and definition of treatment-resistant depression" 53 : 649-659, 2003

16 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" 37 : 193-199, 2017

17 Nasr S, "Comparing outcomes of adjunctive treatment in depression: Aripiprazole versus Bupropion" 162 : 50-54, 2014

18 Zhou X, "Comparative efficacy, acceptability, and tolerability of augmentation agents in treatment-resistant depression: systematic review and network meta-analysis" 76 : e487-e498, 2015

19 Tadori Y, "Characterization of aripiprazole partial agonist activity at human dopamine D 3 receptors" 597 : 27-33, 2008

20 Fava M, "Background and rationale for the Sequenced Treatment Alternatives to Relieve Depression(STAR*D)study" 26 : 457-494, 2003

21 Nelson JC, "Assessment of outcome in depression" 20 : 47-53, 2006

22 Berman RM, "Aripiprazole augmentation in major depressive disorder:a double-blind, placebo-controlled study in patients with inadequate response to antidepressants" 14 : 197-206, 2009

23 Evans KR, "An item response analysis of the Hamilton Depression Rating Scale using shared data from two pharmaceutical companies" 38 : 275-284, 2004

24 Murray CJ, "Alternative projections of mortality and disability by cause 1990-2020 : Global Burden of Disease Study" 349 : 1498-1504, 1997

25 Stahl SM, "A review of the neuropharmacology of bupropion, a dual norepinephrine and dopamine reuptake inhibitor" 6 : 159-166, 2004

26 Hamilton M, "A rating scale for depression" 23 : 56-62, 1960

27 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" 76 : 1521-1531, 2001