度洛西汀与西酞普兰治疗抑郁症的疗效观察

目的 探讨度洛西汀与西酞普兰治疗抑郁症的疗效及安全性.方法 70例抑郁症患者被随机分为度洛西汀组和西酞普兰组.分别在治疗前及治疗后2、4、6、8周以汉密尔顿抑郁量表(HAMD)评价疗效,治疗时出现的症状量表(TESS)评价不良反应.结果 经过8周治疗,两组疗效比较,差异无统计学意义(P＞0.05),不良反应发生率比较差异无统计学意义(P＞0.05),西酞普兰组起效时间早于度洛西汀组.结论 度洛西汀和西酞普兰对抑郁症患者的疗效相当,前者起效时间晚于后者.     

度洛西汀与帕罗西汀治疗抑郁症的对照研究

目的 探讨度洛西汀治疗抑郁症的疗效和安全性.方法 72例抑郁症患者随机分为观察组和对照组各36例,观察组应用度罗西汀治疗,对照组应用帕罗西汀治疗,疗程6周,于治疗前和治疗第1、2、4、6周末采用汉密尔顿抑郁量表(HAMD)和临床疗效总评量表(CGI-SI)评价疗效,以治疗中需处理的不良反应症状量表(TESS)评价安全性.结果 治疗后2组各时间点HAMD评分均低于治疗前,差异有统计学意义(P<0.05和P<0.01).治疗后同期2组间HAMD总分比较差异无统计学意义(P>0.05).2组临床疗效比较差异无统计学意义(P>0.05).2组治疗6周末CGI-SI评分均低于治疗前,差异有统计学意义(P<0.01),但2组间比较差异无统计学意义(P>0.05).2组不良反应发生率比较差异无统计学意义(P>0.05).结论 度洛西汀治疗抑郁症与帕罗西汀疗效相当,安全有效.     

度洛西汀合成路线图解

度洛西汀(duloxetine,1),化学名为(γS)-N-甲基-γ-(1-萘氧基)-2-噻吩丙胺,是由美国Eli Lilly公司研发的5-羟色胺(5-HT)和去甲肾上腺素(NE)双重再摄取抑制剂[1].2002年9月美国FDA批准用于治疗重型抑郁症,临床用盐酸盐,商品名Cymblta.     

辩证行为疗法联合度洛西汀治疗伴自杀倾向抑郁症患者的近期随访研究

目的:探讨辨证行为疗法(DBT)联合度洛西汀治疗伴自杀倾向抑郁症患者的效果.方法:选取2018-08～ 2020-08河南科技大学第五附属医院78例伴自杀倾向抑郁症患者,依照治疗方案分为研究组39例、对照组39例.对照组给予度洛西汀治疗,研究组给予DBT联合度洛西汀治疗,比较两组疗效、治疗前、治疗8周后汉密尔顿抑郁量表(HAMD)评分、社会功能缺陷筛选量表(SDSS)评分、治疗前及治疗1周、治疗4周、治疗8周Beck自杀意念量表中文版(BSICV)评分.结果:研究组治疗总有效率92.31％(36/39)高于对照组64.10％(25/39)(P＜0.05);治疗1周、治疗4周、治疗8周研究组BSICV评分低于对照组(P＜0.05);治疗8周后研究组HAMD评分、SDSS评分低于对照组(P＜0.05).结论:DBT联合度洛西汀治疗伴自杀倾向抑郁症患者效果显著,能缓解抑郁症状,减少自杀意念,降低社会功能缺陷.     

度洛西汀与帕罗西汀治疗不同症状抑郁症的比较研究

目的 比较度洛西汀与帕罗西汀治疗不同症状抑郁症的疗效.方法 将126例符合ICD-10抑郁症诊断标准的患者,按不同主诉(精神症状或躯体症状)分为2组,每组再随机分为2个亚组,分别采用度洛西汀(每天60 mg)和帕罗西汀(每天20 mg)治疗6周,用汉密尔顿抑郁量表(HAMD)评定疗效,用副反应量表(TESS)评定药物不良反应.结果 在以精神症状为主的患者中,度洛西汀组与帕罗西汀组的有效率分别为84%和75%,两者比较差异无显著性(P>0.05);在以躯体症状为主的患者中,度洛西汀组与帕罗西汀组的有效率分别为80%和55%,两者比较差异有显著性(P<0.05).结论 与帕罗西汀相比,度洛西汀治疗伴有躯体症状的抑郁症患者疗效更好.     

度洛西汀联合小剂量奥氮平治疗抑郁症临床疗效观察

目的观察度洛西汀联合小剂量奥氮平治疗抑郁症的临床疗效和安全性。方法将87例抑郁症患者随机分为观察组44例和对照组43例、观察组给予度洛西汀联合小剂量奥氮平治疗,对照组仅用度洛西汀治疗,疗程为8周。治疗结束后采用汉密尔顿抑郁量表(HAMD)、不良反应量表(TESS)分别评定临床疗效及不良反应。结果两组HAMD评分较治疗前均显著性降低(P<0.05)。治疗后第四、八周末,观察组的HAMD评分显著低于对照组(P<0.05)。两组均未发生严重不良反应,不良反应率差异无显著性(P>0.05)。结论度洛西汀联合小剂量奥氮平治疗抑郁症疗效显著,安全可靠,值得临床推广应用。     

度洛西汀与氟西汀治疗抑郁症临床对照观察

目的 比较度洛西汀与氟西汀对首次住院治疗的抑郁症患者的疗效和不良反应.方法 采用CCMD-3诊断标准,对首次住院的抑郁症患者120例分别用度洛西汀与氟西汀治疗6周.采用汉密尔顿抑郁量表(HAMD)评定疗效,同时观察两药的不良反应.结果 度洛西汀与氟西汀治疗抑郁症疗效相当,差异无显著性(P＞0.05);度洛西汀不良反应较氟西汀少(P＜0.01).结论 度洛西汀与氟西汀治疗抑郁症疗效相当,但度洛西汀不良反应少,患者依从性相对较好.     

度洛西汀与帕罗西汀治疗以躯体疼痛为主诉的老年抑郁症患者的对照研究

目的 比较度洛西汀与帕罗西汀治疗以躯体疼痛为主诉的老年抑郁症患者的疗效和安全性.方法 将90例以躯体疼痛为主诉的老年抑郁症患者随机分成两组.分别口服度洛西汀和帕洛西汀治疗,疗程为6周.根据汉密尔顿抑郁量表(HAMD)减分率评定抗抑郁疗效.根据疼痛量表(MOSPM)评定躯体疼痛改善效果.用副反应量表(TESS)评定用药的安全性.结果 度洛西汀组有效率88.9％(40/45),帕罗西汀组有效率82.2％(37/45).在治疗1、2、4周末,两组HAMD差异均有统计学意义(P＜0.05),而治疗6周末起差异无统计学意义(P＞0.05).在治疗1、2、4、6周后度洛西汀组MOSPM评分明显低于帕罗西汀组,差异具有统计学意义(均P＜ 0.05).结论 度洛西汀治疗老年抑郁症总体疗效与帕罗西汀相当,但度洛西汀起效快,且能较快改善躯体疼痛症状,安全性高,依从性好,比帕罗西汀更适合老年抑郁症伴躯体疼痛患者的治疗.     

盐酸度洛西汀治疗抑郁症的临床研究

目的探讨盐酸度洛西汀治疗抑郁症的临床疗效。方法采用开放性、前瞻性方法,对36例抑郁症患者进行盐酸度洛西汀治疗,用HAMD总分以及各因子分全面评定疗效。结果治疗前后患者HAMD总分、焦虑/躯体化、睡眠障碍、阻滞因子分有明显的下降,差异有显著性。结论盐酸度洛西汀治疗抑郁症起效快,副反应小,安全性高,值得临床应用。     

关于度洛西汀与米安色林治疗老年抑郁症的对照分析

目的:对度洛西汀和米安色林分别治疗老年抑郁症的疗效与安全性进行对照研究.方法:将本院在近年来收治的老年抑郁症患者共计100例作为研究对象,随机分为两组:度洛西汀组与米安色林组,应用汉密尔顿抑郁量表(HAMD)对治疗的效果进行评定,应用副反应量表(TESS)与实验室检查评定患者出现的副反应,观察时间为8个星期.结果:两组应用HAMD进行评分,结果显示没有显著差异.但在治疗之后,度洛西汀组在HAMD量表中的精神性、躯体性焦虑方面下降明显,经比较,有显著差异(P<0.01).结论:应用度洛西汀治疗老年抑郁症能够取得显著的效果,不良反应少,患者的依从性好,值得在临床上推广.     

度洛西汀：一种新型抗抑郁药

度洛西汀是一种新型的抗抑郁药,为5-羟色胺和去甲肾上腺素再摄取的双重抑制剂。目前发现不仅可以治疗抑郁症,还可用于治疗压力性尿失禁与糖尿病周围神经病性疼痛。对于抑郁症伴发慢性疼痛也有一定的疗效。常见不良反应为：恶心、口干、失眠、头晕、便秘、食欲减退、乏力及嗜睡等。本文就近年来该药的研究进展作一综述。     

度洛西汀治疗慢性酒依赖伴抑郁的临床疗效研究

目的：探讨度洛西汀在慢性酒依赖伴抑郁患者中的临床疗效及安全性。方法：将符合条件的66例慢性酒依赖伴抑郁患者随机分成两组,分别给予度洛西汀联合常规戒酒治疗（研究组）和常规戒酒治疗（对照组）,进行8周的系统治疗,使用HAMD（汉密尔顿抑郁量表）,HAMA（汉密尔顿焦虑量表）,CGI（临床疗效总体评估量表）,饮酒渴求度评估其疗效;以 TESS （副反应量表）和有关的实验室检查评定药物副反应。结果：治疗以后,研究组与对照组相比较,研究组第1、2、4、8周 HAMD-17、HAMA 、CGI 评分明显下降（P〈0.05或 P〈0.01）;与对照组相比,研究组第1、2、4、8周的饮酒渴求度明显降低（P〈0.05或 P〈0.01）。结论：度洛西汀治疗酒依赖伴抑郁安全有效,并能明显降低酒依赖患者的心理渴求。     

The relationship between antidepressant and analgesic responses: findings from six placebo-controlled trials assessing the efficacy of duloxetine in patients with major depressive disorder

Objective: Debate continues regarding whether onset of analgesia is faster than antidepressant effect in antidepressants with both properties. Duloxetine hydrochloride (from here on referred to as duloxetine) is effective in both major depressive disorder and diabetic peripheral neuropathic pain. This post-hoc analysis of six placebo-controlled duloxetine trials in patients with major depressive disorder was designed to compare onset of antidepressant activity to pain relief.

Research design and methods: Duloxetine was administered at 40–120 mg/day versus placebo for up to 9 weeks in outpatient clinic settings. The primary depression measure was the HAMD₁₇ and pain severity was measured using visual analog scale (VAS) measuring overall pain, headache, back and shoulder pain, and pain while awake. The time course of improvement was profiled using repeated measures modeling and Kaplan–Meier product limit estimation.

Results: In all but one case, significant reductions in HAMD₁₇ and VAS scores were seen within 2 weeks of treatment. Median time to VAS response was consistently shorter across all VAS measures than that to HAMD₁₇ response in both placebo- and duloxetine-treated patients with at least modest levels of pain at study entry. Regression analyses consistently demonstrated little association between analgesic and antidepressant responses. Limitations of these findings include that the studies used in these analyses did not require the patients to enroll with any specific level of pain. Moreover, the type of pain exhibiting at presentation was not routinely identified; therefore, the impact of different pain types on these findings is unknown.

Conclusions: Duloxetine's analgesic effect is independent of the drug's antidepressant effect. Additionally, faster onset of the analgesic effect appears to be a population-specific phenomenon that is unmodified in the presence of active agents.     

Duloxetine: a new selective and dual-acting antidepressant

Antidepressants that inhibit the re-uptake of serotonin and noradrenaline might offer a chance to reduce the multiple symptoms of depression, as both serotonin and noradrenaline seem to be responsible for the emotional and physical symptoms of depression. The potential superiority of a dual mechanism of action has already been demonstrated in a number of clinical trials. Duloxetine, a novel dual acting, selective serotonin and noradrenaline-re-uptake inhibitor, has demonstrated high remission rates and good efficacy on physical symptoms, especially painful physical symptoms of depression. The results from studies in diabetic neuropathic pain provide further evidence of the effect of duloxetine on pain, independent of its effect on depression. Therefore, duloxetine provides an alternative to current therapeutic options in the treatment of the different symptoms of depression.     

Antidepressant agents for the treatment of chronic pain and depression

Depression and painful somatic symptoms commonly occur together. Depression and chronic pain can have devastating effects on a patient's health, productivity, and overall quality of life. When moderate-to-severe pain exists, it can impair patient function while making treatment more difficult or resistant, with increased severity in depressive symptoms and worse outcomes. A variety of chronic pain syndromes exist, including diabetic neuropathy. A high prevalence of patients with chronic pain display depressive symptoms. Treatment for these conditions relies on pharmacologic therapy coupled with diligent, periodic assessments of changes in symptom severity. The link between pain and depression lies in the central and peripheral nervous systems. The brain stem serves as an important connection between the higher brain centers and the spinal cord. In the brain stem, the neurotransmitters serotonin and norepinephrine modulate pain transmission through ascending and descending neural pathways. Both serotonin and norepinephrine are also key neurotransmitters involved with the pathophysiology of depression. Tricyclic antidepressants are effective treatments for pain and depression; selective serotonin reuptake inhibitors provide less benefit. Duloxetine and venlafaxine, which are serotonin and norepinephrine reuptake inhibitors, were shown in clinical trials to alleviate pain and depressive symptoms. Diabetic neuropathy and other chronic pain syndromes were also shown to benefit from duloxetine and venlafaxine. Antidepressants remain fundamental therapeutic agents for depression and anxiety disorders. Their extended use into chronic pain, depression with physical pain, physical pain with or without depression, and other potential medical conditions should be recognized.     

Is there a place for duloxetine?

Duloxetine, a combined serotonin and norepinephrine reuptake inhibitor, is licensed in the UK under two brand names for a total of three different indications. It is available as Cymbalta (jointly promoted by Boehringer Ingelheim and Lilly) for the treatment of patients with major depression, or with diabetic peripheral neuropathic pain; and as Yentreve (Lilly) for the treatment of women with "moderate to severe" stress urinary incontinence. Here we consider whether duloxetine has a role in the treatment of patients with any of these conditions.     

Duloxetine: a new serotonin/noradrenaline reuptake inhibitor for the treatment of depression

Double-blind, placebo-controlled clinical trials have evaluated and demonstrated the efficacy of duloxetine as an antidepressant in patients with major depressive disorders. The drug has been noted to be well tolerated and effective in the control of depressive symptoms. In addition, duloxetine has been shown to be better than placebo and as effective as paroxetine as an antidepressant and also better than placebo for reducing pain in both experimental models and patients. Duloxetine is a safe and well-tolerated new treatment option for depression including anxiety and painful physical symptoms. Furthermore, duloxetine has proven robust efficacy in stress urinary incontinence.     

度洛西汀联合乌灵胶囊治疗中重度抑郁症的临床观察

目的：观察度洛西汀联合乌灵胶囊治疗中重度抑郁症的临床疗效。方法：收集2013年7～12月河北大学附属医院心理咨询与治疗门诊中重度抑郁症患者151例,随机分为3组：单纯度洛西汀用药组,单纯乌灵胶囊组和度洛西汀联合乌灵胶囊组。观察3组药物对治疗中重度抑郁症的临床疗效。结果：度洛西汀治疗抑郁起效快,但对失眠的疗效不好,乌灵胶囊起效慢,但有很好的助眠作用。结论：度洛西汀联合乌灵胶囊治疗中重度抑郁症疗效显著。     

Duloxetine: new indication. Depression and diabetic neuropathy: too many adverse effects

(1) Several classes of antidepressants are available. The main difference between these classes is in their short-term pharmacological effects, leading to different patterns of adverse effects. Some antidepressants, especially tricyclics, have positive risk-benefit balances in the treatment of diabetic neuropathy. (2) Duloxetine, a compound chemically related to fluoxetine, appears to have a short-term mechanism of action similar to that of venlafaxine. In the European Union, duloxetine was first approved for female urinary stress incontinence. Another brand of duloxetine has since been marketed for depression and neuropathic pain in diabetic patients. (3) Duloxetine at a dose of 60 mg once a day showed moderate efficacy in 2 placebo-controlled trials. At this dose, however, there are no other comparative trials. It is therefore not possible to know whether duloxetine is as effective as other antidepressants. (4) Two placebo-controlled trials involving patients with pain due to diabetic neuropathy concluded that a dose of 60 mg/day had efficacy, although of doubtful clinical relevance. In the absence of comparative trials, however, we do not know if this efficacy is even equivalent to that of a tricyclic antidepressant used as an analgesic. (5) In fibromyalgia, a controversial clinical diagnosis, two double-blind placebo-controlled trials involving 207 and 354 patients failed to prove that duloxetine had tangible analgesic efficacy. It is therefore appropriate that this use is not mentioned in the "Indications" section of the summary of product characteristics (SPC). (6) The assessment of duloxetine in depression and neuropathic pain confirms existing data on its gastrointestinal, neuropsychological and hepatic adverse effects. In these trials, duloxetine increased blood pressure in a dose-dependent manner. (7) Duloxetine is metabolized by cytochrome P450 isoenzymes CYP 1A2 and CYP 2D6, creating an important risk of interactions with other drugs. (8) In practice, duloxetine currently has no place in the treatment of depression or diabetic neuropathy. Its efficacy has not yet been demonstrated to be even equivalent to that of other available drugs, and it has too many adverse effects, given this degree of uncertainty.     

度洛西汀治疗海洛因依赖者的抑郁焦虑症状疗效观察

目的：对新型抗抑郁药物度洛西汀胶囊对海洛因依赖者的抑郁及焦虑症状的疗效观察。方法：对31例海洛因依赖并伴抑郁焦虑者应用度洛西汀胶囊进行治疗,疗程为3周。采用汉密尔顿焦虑量表（HAMA）及汉密尔顿抑郁量表（HAMD）两种量表进行评定疗效,用不良反应量表CRESS）对不良反应进行评定。HAMD、HAMA、TESS分别于治疗前、治疗后进行评定。结果：治疗后,度洛西汀组与对照组比较,评分统计学差异显著。结论：新型抗抑郁药物度洛西汀在显著改善海洛因依赖者抑郁焦虑症状的疗效显著,且不良反应小。