ORAL 5'-METHYLTETRAHYDROFOLIC ACID IN SENILE ORGANIC MENTAL-DISORDERS WITH DEPRESSION - RESULTS OF A DOUBLE-BLIND MULTICENTER STUDY

被引:90
作者
PASSERI, M [1 ]
CUCINOTTA, D [1 ]
ABATE, G [1 ]
SENIN, U [1 ]
VENTURA, A [1 ]
BADIALE, MS [1 ]
DIANA, R [1 ]
LAGRECA, P [1 ]
LEGRAZIE, C [1 ]
机构
[1] BIORES SPA,CLIN RES DEPT,VIA FOSSE ARDEATINE 2,I-20060 LISCATE,ITALY
来源
AGING-CLINICAL AND EXPERIMENTAL RESEARCH | 1993年 / 5卷 / 01期
关键词
DEMENTIA; DEPRESSION; 5'-METHYLTETRAHYDROFOLIC ACID; TRAZODONE;
D O I
10.1007/BF03324128
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
5'-Methyltetrahydrofolic acid (5'-MTHF) in addition to standard psychotropic medication significantly improved clinical recovery in depressed patients with borderline or definite folate deficiency, and significantly reduced depressive symptoms in elderly normofolatemic patients after 3 weeks of treatment. In this equivalence study the effect of 5'-MTHF on depressive symptoms and cognitive status was compared to Trazodone (TRZ) in normofolatemic elderly patients with mild to moderate dementia and depression. Ninety-six patients with dementia, scoring 12-23 at the Mini Mental State Examination (MMSE) and greater-than-or-equal-to 18 at the Hamilton Depression Rating Scale (HDRS) after a 2-week placebo run-in, were randomized to receive either 5'-MTHF (50 mg/day p.o.) (47 patients) or TRZ (100 mg/day p.o.) (49 patients) in a double-blind design for 8 weeks. HDRS was assessed before, after 4 weeks and at the end of treatment; Rey's Verbal Memory (RVM) test for immediate and delayed recall was evaluated before and after treatment. After 4 weeks of treatment HDRS score was reduced from 23+/-5 to 20+/-6 in the 5'-MTHF (p<0.05 vs baseline), and from 23+/-3 to 21+/-4 in the TRZ group (p<0.05 vs baseline). A further significant decrease to 18+/-6 and 19+/-5 respectively was obtained at the end of the treatment period (p<0.05 vs week 4) with 5'-MTHF and TRZ. HDRS was administered again after a 4-week, drug-free, follow-up period: no change vs the post treatment scores was observed either in the 5'-MTHF or in the TRZ group (18+/-7 and 19+/-5 respectively). RVM test for immediate recall was significantly improved (p<0.05) at week 8 vs baseline in the 5'-MTHF group whereas no significant change occurred in the TRZ group. No change in delayed recall was observed after treatment in either group. Tolerability was good for both treatments. This study shows that 5'-MTHF and TRZ are equally effective in improving depressive symptoms in patients with mild to moderate dementia and suggests that pharmacological doses of 5'-MTHF may exert psychotropic effects irrespective of folate status.
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页码:63 / 71
页数:9
相关论文
共 46 条
[1]  
Tomlinson B.E., Blessed G., Roth M., Observations on the brains of demented old people, J. Neurol. Sci., 11, pp. 205-242, (1970)
[2]  
Fischer P., Simanyi M., Danielczyk W., Depression in Dementia of the Alzheimer type and in Multi-In- farct Dementia, Am. J. Psychiatry, 147, pp. 1484-1487, (1990)
[3]  
Reifler B.V., Larson E., Teri L., Poulsen M., Dementia of the Alzheimer’s type and depression, J. Am. Geriatr. Soc., 34, pp. 855-859, (1986)
[4]  
Reifler B.V., Teri L., Raskind M., Veith R., Barnes R., White E., McLean P., Double-blind trial of imipramine in Alzheimer’s disease patients with and without depression, Am. J. Psychiatry, 146, pp. 45-49, (1989)
[5]  
Rovner B.W., Broadhead J., Spencer M., Carson K., Folstein M.F., Depression and Alzheimer’s disease, Am. J. Psychiatry, 146, pp. 350-353, (1989)
[6]  
Greenwald B.S., Kramer-Ginsberg E., Marin D.B., Laitman L.B., Hermann C.K., Mohs R., Davis K.L., Dementia with Coexistent Major Depression, Am. J. Psychiatry, 146, pp. 1472-1478, (1989)
[7]  
Potter W.Z., Rudorfer H.V., Manji H., The pharmacologic treatment of depression, N. Engl. J. Med., 325, pp. 633-642, (1991)
[8]  
Altamura A.C., Mauri M.C., Colacurcio F., Scapicchio P.L., Hadjchristos C., Carucci G., Minervini M., Montanini R., Perini M., Rudas N., Carpiniello B., D'Aloise A., Malinconico A., Trazodone in late life depressive states: a double-blind multicenter study versus amitriptyline and mionserim, Psychopharmacology, 95, pp. 534-536, (1988)
[9]  
Godfrey P.S.A., Toone B.K., Carney M.W.P., Flynn T.G., Bottiglieri T., Laundy M., Chanarin I., Reynolds E.H., Enhancement of recovery from psychiatric illness by methylfolate, Lancet, 336, pp. 392-395, (1990)
[10]  
Guaraldi G.P., Fava M., Mazzi F., La Greca P., Open study on 5 methyltetrahydrofolic acid in the treatment of depression in the elderly, Eur. J. Clin. Invest, 22, (1992)