노인 우울증 환자에서 선택적 세로토닌 재흡수 억제제, 세로토닌 노르에피네프린 재흡수 억제제가 우울증상, 통증 그리고 신체증상에 미치는 효과 비교 = Comparison of Effect of SSRIs and SNRIs on Depression, Pain and Somatic Symptoms in Elderly Patients with Major Depressive Disorder

다국어 초록 (Multilingual Abstract)

Objectives：The aim of this study was to compare the effect of Selective Serotonin Reuptake Inhibitor (SSRI) and Serotonin Norepinephrine Reuptake Inhibitor (SNRI) for mood symptoms, pain, and somatic symptoms in elderly depression patients with pain and somatic symptoms.
Methods：This study is a prospective open-label study conducted by a single institution. A total of 43 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study (average age: 72.53, 58.1% women). The subjects were classified as SSRI and SNRI groups. Depressive symptoms, pain, and somatic symptoms were evaluated by Korean version of the Hamilton Depression Rating Scale (K-HDRS), visual analogue scale (VAS) and Patient Health Questionnare-15 (PHQ-15) respectively at baseline and six weeks later. Two-way repeated-measure ANOVA was performed to analyze changes in the KHDRS, VAS, and PHQ-15 scores.
Results：In the SSRI and SNRI groups, K-HDRS, VAS, and PHQ-15 all showed significant improvement after 6 weeks compared to each baseline values. There were no differences in therapeutic effect between the two groups.
Conclusions：We found that SSRI and SNRI both improved somatic symptoms and pain in elderly depression patients. The results of this study are thought to help select antidepressants when administering medication to elderly depression patients who complain pain and somatic symptoms. Further research is needed on the longterm effects of the SSRI and SNRI.

국문 초록 (Abstract)

연구목적본 연구는 통증 및 신체증상이 동반된 노인 우울증 환자에서 기분증상 및 통증, 신체 증상에 대한 선택적 세로토닌 재흡수 억제제(Selective Serotonin Reuptake Inhibitor, SSRI)와 세로토닌 노르에피네프린 재흡수 억제제(Serotonin Norepinephrine Reuptake Inhibitor, SNRI)의 치료 효과를 비교하기 위해 실시되었다.
방 법본 연구는 단일 기관에서 시행된 전향적 개방연구로 DSM-5 진단기준에 의해 주요우울장애로 진단받은 총43명의 대상자들이 본 연구에 참여하였다(평균연령 : 72.53세, 여성 58.1%). 대상군은 SSRI, SNRI 두 군으로분류되었고 우울, 통증 및 신체증상은 각각 한국판 해밀턴 우울증 평가척도(Korean version of the Hamilton Depression Rating Scale, K-HDRS), 시각적 비율 척도(Visual Analogue Scale, VAS), 환자 건강 설문지(Patient Health Questionnare-15, PHQ-15)를 사용하여 평가되었다. 이원배치 반복측정 분산분석(Two-way repeated-measure ANOVA)으로 약물 투여 전과 투여 후 6주의 KHDRS, VAS, PHQ-15 점수 변화를 분석하였다.
결 과SSRI군과 SNRI군에서 K-HDRS, VAS, PHQ-15 모두 약물 투약 전에 비해 6주 후의 점수가 유의하게 호전되었으며, 두 군 간에 호전 정도의 차이는 없었다.
결 론노인 우울증 환자에서 SSRI, SNRI 모두 통증 및 신체증상을 호전시키는 것으로 나타났다. 본 연구 결과는 통증 및 신체증상을 호소하는 노인 우울증 환자에게 약물치료를 시행할 때 선택할 수 있는 항우울제 처방 결정에도움을 줄 수 있을 것이라고 생각되며, 약물의 장기적인 효과에 대해서 추가적인 연구가 필요할 것으로 보인다.

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