Background: Depression is a common psychiatric comorbidity in individuals with Down syndrome (DS), particularly adults, with an estimated lifetime prevalence of at least 10%. The current literature on the treatment of depression in adults with DS is limited to case series published more than two decades ago, prior to the widespread use of modern antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs). The purpose of this retrospective chart review study was to examine the effectiveness, tolerability, and safety of SSRIs for depression in adults with DS. Methods: Medical records of 11 adults with DS and depression were reviewed. Assignment of scores for severity (S) of symptoms of depression and improvement (I) of symptoms with treatment with an SSRI was made retrospectively using the Clinical Global Impression Scale (CGI). Demographic and clinical characteristics of the study population, SSRI name, dose, and duration of treatment; and adverse effects were also recorded. Results: All 11 patients (7 male, 4 female; mean age = 27.2 years, range 18–46 years) completed a 12-week treatment course with an SSRI. The median duration of time after initiation of the SSRI covered by record review was 2.1 years, with a range of 24 weeks to 6.7 years. Nine of the 11 patients (82%; 95% CI 52%, 95%) were judged responders to SSRIs based on a rating of “much improved” or “very much improved” on the CGI-I after 12 weeks of treatment (median time of follow-up was 14.4 weeks, with a range of 12.0–33.0 weeks). Adverse effects occurred in four patients (36%). The most common adverse effects were daytime sedation and anger. Conclusions: In this preliminary retrospective study, the majority of patients responded to a 12-week course of SSRI treatment and some tolerated long-term use. Controlled studies are needed to further assess the efficacy, tolerability, and safety of SSRIs for the treatment of depression in adults with DS.

中文翻译：

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选择性 5-羟色胺再摄取抑制剂治疗成人唐氏综合症抑郁症：一项初步回顾性图表审查研究

背景：抑郁症是唐氏综合症 (DS) 患者，尤其是成年人中常见的精神共病，估计终生患病率至少为 10%。目前关于治疗成人 DS 抑郁症的文献仅限于二十多年前发表的病例系列，当时还没有广泛使用现代抗抑郁药物，例如选择性 5-羟色胺再摄取抑制剂 (SSRIs)。这项回顾性图表审查研究的目的是检查 SSRIs 治疗 DS 成人抑郁症的有效性、耐受性和安全性。方法：回顾了 11 名患有 DS 和抑郁症的成年人的医疗记录。使用临床总体印象量表 (CGI) 回顾性地对抑郁症状的严重程度 (S) 和用 SSRI 治疗的症状改善 (I) 进行评分。研究人群的人口统计学和临床​​特征、SSRI 名称、剂量和治疗持续时间；并且还记录了不良反应。结果：所有 11 名患者（7 名男性，4 名女性；平均年龄 = 27.2 岁，范围 18-46 岁）均完成了 12 周的 SSRI 疗程。记录审查涵盖的 SSRI 启动后的中位持续时间为 2.1 年，范围为 24 周至 6.7 年。11 名患者中有 9 名（82%；95% CI 52%，95%）根据治疗 12 周后 CGI-I 的“显着改善”或“非常显着改善”评级（中位数）被判断为对 SSRIs 有反应随访时间为 14.4 周，范围为 12.0–33.0 周）。4 名患者（36%）发生了不良反应。最常见的不良反应是白天镇静和愤怒。结论：在这项初步回顾性研究中，大多数患者对 12 周疗程的 SSRI 治疗有反应，一些患者可以长期耐受。需要对照研究进一步评估 SSRIs 治疗 DS 成人抑郁症的疗效、耐受性和安全性。