دورية أكاديمية
Clinical efficacy and safety of low-dose doxepin in Chinese patients with generalized anxiety disorder: A before-after study.
العنوان: | Clinical efficacy and safety of low-dose doxepin in Chinese patients with generalized anxiety disorder: A before-after study. |
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المؤلفون: | Zhang M; Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China., Huang F; Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China., Jiang F; Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China., Mai M; Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China., Guo X; Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China., Zhang Y; Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China., Xu Y; Department of Geriatric Cognitive Disorders, Shanghai Jinshan Zhongren Geriatric Nursing Hospital, Shanghai, China., Zu H; Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China. |
المصدر: | Medicine [Medicine (Baltimore)] 2022 Oct 21; Vol. 101 (42), pp. e31201. |
نوع المنشور: | Randomized Controlled Trial; Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins |
مواضيع طبية MeSH: | Anxiety Disorders*/drug therapy , Doxepin*/administration & dosage , Doxepin*/adverse effects, Female ; Male ; Adrenocorticotropic Hormone ; Blood Glucose/metabolism ; Body Weight ; China ; Cholesterol, LDL ; Controlled Before-After Studies ; Treatment Outcome ; Triglycerides ; Triiodothyronine ; Humans |
مستخلص: | Clinical and animal studies have reported that low-dose doxepin may have positive effects on generalized anxiety disorder (GAD); however, its effectiveness and clinical safety are less well understood. This study is a before-after study and aims to investigate the effectiveness and side effects of low-dose doxepin by evaluating Hamilton Anxiety Scale (HAMA) scores, hormones, blood glucose, serum lipids, body weight, and body mass index (BMI) in patients with GAD. Forty-nine patients (20 males and 29 females) with GAD were randomly assigned to receive low-dose doxepin (6.25 mg-12.5 mg per day) for 12 weeks between February 2015 and March 2016. HAMA scores, fasting blood glucose (FBG) body weight, BMI, and some serum biochemical indexes, such as adrenocorticotropic hormone (ACTH), free triiodothyronine (FT3), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDLC), and FBG, were assessed during pretreatment and post-treatment. Mean scores of HAMA decreased from 19.50 ± 1.22 to 8.50 ± 3.61 after low-dose doxepin treatment (P < .01). The serum levels of ACTH (4.33 ± 2.14 vs 6.12 ± 3.02 pmol/L), FT3 (4.78 ± 0.51 vs 5.15 ± 0.52 pg/mL), TC (4.55 ± 1.01 vs 5.93 ± 1.66 mmol/L), TG (1.69 ± 1.51 vs 3.39 ± 2.86 mmol/L), and LDLC (2.43 ± 0.88 vs 3.76 ± 1.25 mmol/L), and FBG (5.06 ± 0.43 vs 5.78 ± 0.81 mmol/L) were higher than that pretreatment with a significant difference (P < .01). Bodyweight (62.00 ± 7.45 vs 64.00 ± 6.44 kg, P = .23) and BMI (23.70 ± 2.35 vs 24.48 ± 2.11 kg/m2, P = .14) had no difference after treatment. These results suggest that low-dose doxepin has beneficial clinical efficacy and safety. Low-dose doxepin can ameliorate anxiety in GAD patients and has some effects on neuroendocrine systems and the metabolic activity of serum glucose and lipid. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.) |
References: | Battle DE. Diagnostic and statistical manual of mental disorders (DSM). Codas. 2013;25:191–2. Guo X, Meng Z, Huang G, et al. Meta-analysis of the prevalence of anxiety disorders in mainland China from 2000 to 2015. Sci Rep. 2016;6:28033. Bandelow B, Zohar J, Hollander E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders. World J Biol Psychiatry. 2002;3:171–99. Buoli M, Caldiroli A, Caletti E, et al. New approaches to the pharmacological management of generalized anxiety disorder. Expert Opin Pharmacother. 2013;14:175–84. Wilson K, Mottram P. A comparison of side effects of selective serotonin reuptake inhibitors and tricyclic antidepressants in older depressed patients: a meta-analysis. Int J Geriatr Psychiatry. 2004;19:754–62. Wang SM, Han C, Bahk WM, et al. Addressing the side effects of contemporary antidepressant drugs: a comprehensive review. Chonnam Med J. 2018;54:101–12. Hassanzadeh P, Hassanzadeh A. The role of the endocannabinoids in suppression of the hypothalamic-pituitary-adrenal axis activity by doxepin. Iran J Basic Med Sci. 2011;14:414–21. Furukawa TA, McGuire H, Barbui C. Meta-analysis of effects and side effects of low dosage tricyclic antidepressants in depression: systematic review. BMJ.. 2002;325:991. Weber J, Siddiqui MA, Wagstaff AJ, et al. Low-dose doxepin: in the treatment of insomnia. CNS Drugs. 2010;24:713–20. Mansbach RS, Ludington E, Rogowski R, et al. A placebo- and active-controlled assessment of 6- and 50-mg oral doxepin on cardiac repolarization in healthy volunteers: a thorough QT evaluation. Clin Ther. 2011;33:851–62. Bereza BG, Machado M, Einarson TR. Systematic review and quality assessment of economic evaluations and quality-of-life studies related to generalized anxiety disorder. Clin Ther. 2009;31:1279–308. Allgulander C, Bandelow B, Hollander E, et al. WCA recommendations for the long-term treatment of generalized anxiety disorder. CNS Spectr. 2003;8(8 Suppl 1):53–61. Fortney JC, Pyne JM, Edlund MJ, et al. Reasons for antidepressant nonadherence among veterans treated in primary care clinics. J Clin Psychiatry. 2011;72:827–34. Hidalgo RB, Tupler LA, Davidson JR. An effect-size analysis of pharmacologic treatments for generalized anxiety disorder. J Psychopharmacol. 2007;21:864–72. Almasi A, Meza CE. Doxepin. In: StatPearls. Treasure Island (FL): StatPearls Publishing2020. Hajak G, Rodenbeck A, Voderholzer U, et al. Doxepin in the treatment of primary insomnia: a placebo-controlled, double-blind, polysomnographic study. J Clin Psychiatry. 2001;62:453–63. Krystal AD, Durrence HH, Scharf M, et al. Efficacy and safety of doxepin 1 mg and 3 mg in a 12-week sleep laboratory and outpatient trial of elderly subjects with chronic primary insomnia. Sleep. 2010;33:1553–61. Wu J, Chang F, Zu H. Efficacy and safety evaluation of citalopram and doxepin on sleep quality in comorbid insomnia and anxiety disorders. Exp Ther Med. 2015;10:1303–8. Tafet GE, Nemeroff CB. Pharmacological treatment of anxiety disorders: the role of the HPA axis. Front Psychiatry. 2020;11:443. Lewis DA, Sherman BM. Serotonergic stimulation of adrenocorticotropin secretion in man. J Clin Endocrinol Metab. 1984;58:458–62. Fava M. Depression with physical symptoms: treating to remission. J Clin Psychiatry. 2003;64(Suppl 7):24–8. Taylor MJ, Rudkin L, Bullemor-Day P, et al. Strategies for managing sexual dysfunction induced by antidepressant medication. Cochrane Database Syst Rev. 2013;5:CD003382. Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009;29:259–66. Perlis RH, Laje G, Smoller JW, et al. Genetic and clinical predictors of sexual dysfunction in citalopram-treated depressed patients. Neuropsychopharmacology. 2009;34:1819–28. Lam RW, Kennedy SH, Grigoriadis S, et al. Canadian network for mood and anxiety treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. III. Pharmacotherapy. J Affect Disord. 2009;117(Suppl 1):S26–43. Sevincok L, Buyukozturk A, Dereboy F. Serum lipid concentrations in patients with comorbid generalized anxiety disorder and major depressive disorder. Can J Psychiatry. 2001;46:68–71. Li H, Zhang X, Sun Q, et al. Association between serum lipid concentrations and attempted suicide in patients with major depressive disorder: a meta-analysis. PLoS One. 2020;15:e0243847. Uguz F, Sahingoz M, Gungor B, et al. Weight gain and associated factors in patients using newer antidepressant drugs. Gen Hosp Psychiatry. 2015;37:46–8. Andersohn F, Schade R, Suissa S, et al. Long-term use of antidepressants for depressive disorders and the risk of diabetes mellitus. Am J Psychiatry. 2009;166:591–8. Maina G, Albert U, Salvi V, et al. Weight gain during long-term treatment of obsessive-compulsive disorder: a prospective comparison between serotonin reuptake inhibitors. J Clin Psychiatry. 2004;65:1365–71. Masand PS, Gupta S. Long-term side effects of newer-generation antidepressants: SSRIS, venlafaxine, nefazodone, bupropion, and mirtazapine. Ann Clin Psychiatry. 2002;14:175–82. Krystal AD, Lankford A, Durrence HH, et al. Efficacy and safety of doxepin 3 and 6 mg in a 35-day sleep laboratory trial in adults with chronic primary insomnia. Sleep. 2011;34:1433–42. Shenoi SD, Soman S, Munoli R, et al. Update on pharmacotherapy in psychodermatological disorders. Indian Dermatol Online J. 2020;11:307–18. |
المشرفين على المادة: | 9002-60-2 (Adrenocorticotropic Hormone) 0 (Blood Glucose) 0 (Cholesterol, LDL) 1668-19-5 (Doxepin) 0 (Triglycerides) 06LU7C9H1V (Triiodothyronine) |
تواريخ الأحداث: | Date Created: 20221025 Date Completed: 20221026 Latest Revision: 20240226 |
رمز التحديث: | 20240227 |
مُعرف محوري في PubMed: | PMC9592331 |
DOI: | 10.1097/MD.0000000000031201 |
PMID: | 36281170 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1536-5964 |
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DOI: | 10.1097/MD.0000000000031201 |