Аугметация антидепрессантов ингибиторами холинэстеразы

STUDY SELECTION AND DATA EXTRACTION: English-language clinical trials were evaluated. Studies that included subjects with Alzheimer's disease, dementia, Parkinson disease, bipolar disorder, or schizophrenia were excluded. Four clinical studies met our criteria.
DATA SYNTHESIS: We identified 4 randomized, double-blind, placebo-controlled trials that ranged in sample size from 20 to 130. Galantamine 16 mg daily was evaluated in 2 trials lasting 8 and 24 weeks. Neither study found a statistically significant difference in measures of cognition or Hamilton Rating Scale for Depression scores. Donepezil augmentation was evaluated in a 1-year and a 2-year trial. Donepezil was found to improve global cognition at 1 year, but the benefit did not persist at year 2. Subjects with mild cognitive impairment at baseline who received donepezil experienced higher depression recurrence than did those who took placebo (p = 0.03); this effect was not observed in cognitively intact subjects (p = 0.39).
CONCLUSIONS: There is no clear benefit for ChEI therapy as an adjunct to antidepressant therapy for depressed older adults.

Cholinesterase Inhibitor Adjunctive Therapy for Cognitive Impairment and Depressive Symptoms in Older Adults with Depression