托吡酯联合舍曲林治疗双相抑郁急性发作的对照研究

目的 评价与拉莫三嗪联合舍曲林治疗双相抑郁急性发作相比,托吡酯联合舍曲林治疗双相抑郁的疗效及安全性.方法 将符合CCMD -3双相抑郁诊断标准的68例患者随机进入拉莫三嗪联合舍曲林组(研究组)或托吡酯联合舍曲林组(对照组)接受治疗,最终研究组有30例和对照组有34例完成治疗,分别在治疗前和1、2、4、6、8周末评定HAMD、HAMA、TESS总分.结果 两组间HAMD、HAMA评分在第4、6周末具有统计学意义(P＜0.01,P＜0.05).两组内各阶段末HAMD、HAMA评分具有统计学意义(P＜0.01),提示托吡酯联合组与拉莫三嗪联合组对双相抑郁急性发作有效.两组TESS不良反应在第2、4周末差异具有统计学意义(P＜0.01).结论 托吡酯联合舍曲林治疗双相抑郁在疗效方面,有效且起效时间快;在安全性方面,托吡酯联合舍曲林治疗双相抑郁时不良反应较早出现,但经过持续坚持观察治疗后,在不良反应方面与拉莫三嗪联合舍曲林治疗双相抑郁的不良反应相当.

The control study of topiramate or lamotrigine combined with sertraline for the acute episode of bipolar depression

Objective To evaluate the efficacy and safety of topiramate combined with sertraline in comparing to lamotrigine combined with sertraline in the treatment of bipolar depression in acute episode. Methods 68 patients who met the diagnosis criteria for acute episode of bipolar depression in CCMD--3 entered this study. All patients were randomly divided into two groups. At the end of the study, 30 patients in topiramate group and 34 patients in lamotrigine group finished the study. All patients were assessed by HAMD, HAMA and TESS in the 0, 1, 2, 4, 6 and 8 week of treatment. Results The two groups scored significantly different in HAMD and HAMA at wks 4 and 6 （P〈0.01 or P〈0.05）. It suggested that both topiramate and lamotrigine in combination with sertraline could treat bipolar depres- sion in acute episode. Two groups scored significantly different in TESS in wks 2 and 4 （P〈0.01）. Conclusions Topiramate combined with sertraline was effective in treatment of bipolar depression, and the efficacy occurred faster. The side effects of topiramate in the treatment of bipolar depression appeared earlier than that of lamotrigine combined with sertraline, but it was found that the total side effects of topiramate and lamotrigine combined sertraline in the continuous treatment of bipolar depression was not different.