乙酰左旋肉碱和氨磺必利
目前已有研究比较了乙酰左旋肉碱和氨磺必利(一种非典型的抗精神病类药物)用于治疗心境恶劣障碍的效果,结果显示两种药物对于缓解抑郁有同等效果。[86]Zanardi R, Smeraldi E. A double-blind, randomised, controlled clinical trial of acetyl-L-carnitine vs. amisulpride in the treatment of dysthymia. Eur Neuropsychopharmacol. 2006;16:281-287.http://www.ncbi.nlm.nih.gov/pubmed/16316746?tool=bestpractice.com对于心境恶劣老年患者,乙酰左旋肉碱与氟西汀有同等疗效,可能还对改善主观认知症状有效。[87]Bersani G, Meco G, Denaro A, et al. L-Acetylcarnitine in dysthymic disorder in elderly patients: a double-blind, multicenter, controlled randomized study vs. fluoxetine. Eur Neuropsychopharmacol. 2013;23:1219-1225.http://www.ncbi.nlm.nih.gov/pubmed/23428336?tool=bestpractice.com值得注意的是,这些研究都没有纳入安慰剂对照因素,从而对得出的关于疗效的结论具有限制性。
脱氢表雄酮 (DHEA)
DHEA 是一种肾上腺雄激素。已经对其治疗心境恶劣中年起病患者的效果进行评估,证据显示其能缓解抑郁症状,提示心境恶劣中年起病可能是激素改变的结果。[88]Bloch M, Schmidt PJ, Danaceau MA, et al. Dehydroepiandrosterone treatment of midlife dysthymia. Biol Psychiatry. 1999;45:1533-1541.http://www.ncbi.nlm.nih.gov/pubmed/10376113?tool=bestpractice.com[89]Schmidt PJ, Daly RC, Bloch M, et al. Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression. Arch Gen Psychiatry. 2005;62:154-162.http://archpsyc.ama-assn.org/cgi/content/full/62/2/154http://www.ncbi.nlm.nih.gov/pubmed/15699292?tool=bestpractice.com[90]Soares CN, Zitek B. Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability? J Psychiatry Neurosci. 2008;33:331-343.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440795/?tool=pubmedhttp://www.ncbi.nlm.nih.gov/pubmed/18592034?tool=bestpractice.com