Behavioral screen for antidepressants: The effects of drugs and electroconvulsive shock on performance under a differential-reinforcement-of-low-rate schedule

Those antidepressant drugs that are, in wide clinical use decrease response rate and increase reinforcement rate when administered to rats performing on a differential-reinforcement-of-low-rate 72-s (DRL 72-s) schedule. Drugs that are not antidepressants do not have this effect. In this experiment, the following were examined for their effects on a DRL 72-s schedule: tranzodone, zimelidine, fluoxetine, and bupropion (atypical antidepressants); electroconvulsive shock (ECS, which is an effective treatment for depression); and haloperidol and clozapine (antipsychotic drugs). Trazodone (3.12–25.00 mg/kg), fluoxetine (10–20 mg/kg), and ECS decreased response rate and increased reinforcement rate. Zimelidine (20 mg/kg) increased reinforcement rate and nonsignificantly decreased response rate. At doses between 2.5 and 40 mg/kg, bupropion had no effect on reinforcement rate or response rate, but at 60 mg/kg response rate was increased and reinforcement rate was nonsignificantly decreased. At the higher dose, the effects of bupropion resemble those of a psychomotor stimulant. Haloperidol (0.04 mg/kg) and clozapine (2.5–10.0 mg/kg) decreased response rate and reinforcement rate. These results, suggest that the DRL 72-s schedule may be useful for testing the antidepressant potential of new drugs.     

美抒玉与阿米替林治疗抑郁症的临床对照研究

目的评价美抒玉与阿米替林治疗抑郁症的临床疗效和安全性。方法将47例符合CCMD-3抑郁症诊断标准的抑郁症患者随机分为两组，分别给予美抒玉和阿米替林治疗，于治疗前和治疗后1，2，4，6周末分别采用汉密顿抑郁量表、临床疗效总体评定量表及不良反应量表评定、结果美抒玉与阿米替林总体疗效相似，两组比较无显著差异（P〉0．05）。美抒玉组治疗第二周就起效，两组治疗前与治疗后比较HAMD量表均有显著性差异（P〈0．01），两组之间比较无显著性差异（P〉0．05），美抒玉组的不良反应少于阿米替林组。结论美抒玉是一种安全有效的新一代抗抑郁药物，适合伴有失眠症状的抑郁病人使用。     

曲唑酮与阿普唑仑治疗广泛性焦虑症的对照研究

目的　比较曲唑酮与阿普唑仑治疗广泛性焦虑症的疗效及副作用。方法　选择符合CCMD 2 R诊断标准的广泛性焦虑症病例 6 3例 ,随机分为曲唑酮组 (34例 )和阿普唑仑组 (2 9例 )。分别用曲唑酮 5 0～ 15 0mg/日 ,阿普唑仑 0 8～ 2 4mg/日 ,治疗观察 12周。用汉密尔顿焦虑量表(HAMA)和药物副反应量表 (TESS) ,评定疗效和药物的不良反应。结果　曲唑酮与阿普唑仑疗效相当 ,起效稍慢于阿普唑仑 ,但中长期疗效更持久 ,没有严重副反应及药物依赖性。结论　曲唑酮治疗广泛性焦虑症疗效好 ,副反应轻 ,患者服药依从性好     

曲唑酮治疗苯二氮（艹卓）类药物戒断症状临床观察

目的　验证曲唑酮对苯二氮类药物戒断症状的疗效及安全性。方法　对 30例患者分别以曲唑酮与安慰剂配合递减法进行治疗 ,共治疗 4周。采用戒断症状记分 (2 2项 )及汉密尔顿焦虑量表 (HAMA)评定疗效。结果　曲唑酮组与安慰剂组治疗后戒断症状记分及HAMA减分比较差异有极显著性 (P <0 .0 1) ,曲唑酮的主要副反应为口干、困倦。结论　曲唑酮治疗苯二氮类药物戒断症状疗效较好 ,具有较好的应用前景     

心理干预合并曲唑酮治疗原发性高血压伴抑郁焦虑的疗效观察

目的　观察心理干预并曲唑酮对原发性高血压伴抑郁或焦虑情绪患者的疗效 ,寻找治疗最佳方案 .方法原发性高血压患者经汉密顿抑郁量表 17项 (HAMD)及汉密顿焦虑量表 14项 (HAMA)评分 ,其中抑郁或焦虑分分别超过 17或 14分者随机分成 3组 :A组为对照组 ,只用降压药物治疗 ;B组为降压治疗合并心理干预 ;C组降压并心理干预再加用曲唑酮治疗 .治疗 4周后用HAMD及HAMA量表评分 ,并记录血压变化 .结果　治疗后C组收缩压和舒张压降低较B组和A组明显 (p <0 .0 1,p <0 .0 0 1) .HAMD及HAMA总分C组降低较B组、A组明显 (p <0 .0 1,p <0 .0 0 1,p <0 .0 5 ) .结论　综合心理干预合并曲唑酮治疗对高血压伴心理障碍者有良好作用     

曲唑酮治疗继发性早泄疗效相关文献的系统评价

目的参照Cochrane体系,系统评价曲唑酮治疗继发性早泄患者的相关文献,探讨曲唑酮治疗继发性早泄的临床疗效。方法通过检索1995年1月至2015年1月期间中国学术期刊数据库等8个数据库内相关的随机对照试验(RCT),严格评价纳入文献质量和资料提取,使用Stata/SE version 12.0软件进行系统评价。结果最终纳入7篇RCT,共542例患者,其中实验组203例(予以曲唑酮)、对照组194例(予以安慰剂)。系统评价结果显示:相比使用安慰剂的对照组,经曲唑酮治疗后第2周的阴道内射精潜伏期显著延长[SMD 1.28,95%CI(0.98,1.57)],第4周的阴道内射精潜伏期显著延长[SMD 4.09,95%CI(2.56,5.62)],并且患者对性生活的满意度显著提升[RR1.39,95%CI(1.07,1.79)];经偏倚性验证,上述结论稳健,具有推广性。结论经曲唑酮治疗继发性早泄,能显著延长患者的阴道内射精潜伏期、提升患者性生活满意度,其疗效确切,值得临床推广。     

Evaluation of cytogenetic and DNA damage induced by the antidepressant drug-active ingredients,trazodone and milnacipran,in vitro

Trazodone and milnacipran are the active antidepressant drugs that are being used in the treatment of psychiatric disorders. In this study, the in vitro genotoxic effects of trazodone and milnacipran have been determined in human peripheral blood lymphocytes by using chromosomal aberrations (CAs), sister chromatid exchanges (SCEs), micronuclei (MN), and comet assays. 3.13; 6.25; 12.50; 25.00; 50.00; and 75.00?μg/mL concentrations of trazodone and 2.50; 5.00; 10.00; 20.00; 30.00; and 40.00?μg/mL concentrations of milnacipran were used. Trazodone and milnacipran significantly increased the frequency of CAs and SCEs compared with the control. Both of the active ingredients raised the MN frequency in a dose-dependent manner. Mitotic index was significantly decreased, but replication and nuclear division indices were not affected at all treatments. Trazodone was statistically increased the mean comet tail intensity, tail length, and tail moment at three concentrations (6.25; 12.50; and 25.00?μg/mL) compared with control. Two highest concentrations (50 and 75?μg/mL) of trazodone were toxic in the comet assay. Milnacipran increased the comet tail intensity, tail length, and tail moment at all concentrations. It is concluded that trazodone and milnacipran have clastogenic, mutagenic, and cytotoxic effects on human lymphocytes in vitro.     

美沙酮联合曲唑酮治疗海洛因依赖的临床研究

目的:观察美沙酮联合曲唑酮对海洛因依赖患者脱毒治疗的疗效及副反应.方法:海洛因依赖患者137例,随机分为两组:研究组(美沙酮联合曲唑酮)65例和对照组(单用美沙酮)72例.采用戒断症状评定量表、汉密顿焦虑评定量表(HAMA)和汉密顿抑郁量表(HAMD)评定患者的戒断反应、焦虑症状及睡眠障碍.结果:研究组在戒断反应、焦虑及睡眠障碍与对照组相比较,差异均有显著性(P＜0.05,或P＜0.01).两组副反应差异无显著性(P＞0.05).结论:美沙酮合并曲唑酮用于海洛因依赖者的脱毒治疗的疗效满意,副反应较少.     

曲唑酮合并美沙酮治疗海洛因依赖者临床对照研究

目的：观察曲唑酮合并美沙酮治疗海洛因依赖者的脱毒疗效、安全性和依从性。方法：随机抽取30例脱毒病人作为治疗组，接受曲唑酮合并美沙酮治疗，对照组病人与之相匹配30例，单一使用美沙酮，疗程共二周，使用戒断症状量表，HAMA，HAMD评定结果。结果：治疗组病人疗效对照组明显优越，副反应少，同时减少了美沙酮的剂量。结论：曲唑酮合并美沙酮治疗海洛因依赖者的疗效比单一使用美沙酮治疗优越，合并治疗副反应少，安全性好，值得临床推广。     

Clinical and polysomnographic effects of trazodone CR in chronic insomnia associated with dysthymia

Six middle aged subjects complaining of chronic insomnia associated with dysthymia were investigated in a 2-month single blind study: a 7-day placebo treatment period, followed by a 6-week phase with increasing doses of trazodone controlled release (CR) formulation (50 mg through days 8–10; 75 mg through days 11–13; 150 mg through days 14–49) and then a final 7-day withdrawal period under placebo. Medication was always administered at bedtime. Five polysomnographic recordings were accomplished by each subject (sleep 1: under baseline placebo; sleep 2-3-4: under active treatment; sleep 5: after drug discontinuation). A blind EEG reader analysed the traditional polysomnographic variables (macrostructure of sleep) and the amount and percentage ratio (CAP rate) of cyclic alternating pattern (CAP), the microstructural parameter that measures the instability of arousal during sleep. Visual analogue scales (VAS) for the evaluation of subjective sleep quality and the Hamilton rating scale for depression (HAM-D) were regularly assessed across the study. Statistical analysis was based on an ANOVA test with repeated measures completed by means of Bonferroni adjusted probabilities. No significant differences emerged from the macrostructural parameters referred to sleep initiation and maintenance, while significant overall modifications emerged from stage 2 (P<0.0005), slow wave sleep (P<0.0001), total CAP time (P<0.0001) and CAP rate (P<0.0001). Compared to the placebo baseline night, a significant increase of slow wave sleep (+40 min) and significant reductions of stage 2 (–67 min), CAP time (–90 min) and CAP rate (–23%) were already found on day 4 of treatment (sleep 2). These changes maintained significance throughout the active treatment period (sleep 3 and sleep 4), while a return to the baseline values occurred after drug discontinuation (sleep 5). The course of polysomnographic modifications was consistently associated with significant improvement of VAS and HAM-D scores during the active treatment period and by poor scores of the baseline and withdrawal periods. Trazodone appears to have a high affinity for 5-HT₂ receptors. The availability of an effective slow acting serotonin-related drug with both sedative and antidepressant properties may open new perspectives in the treatment of chronic insomnia.