丁螺环酮与氟西汀联合治疗抑郁症临床研究

目的：探讨丁螺环酮与氟西汀联合治疗抑郁症的疗效。方法：抑郁症患者65例，随机分成两组，分别用丁螺环酮联合氟西汀治疗(联用组)和单用氟西汀治疗(单用组)，疗程6周。采用汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)评定疗效，用不良反应量表(TESS)评定不良反应。结果：治疗6周后联用组HAMD和HAMA评分显著低于单用组；在第2、第6周末联用组的治疗有效率显著高于单用组。两组不良反应相仿。结论：丁螺环酮联合氟西汀治疗抑郁症有良好的疗效。     

丁螺环酮联合马普替林与马普替林单独治疗抑郁症的疗效对照观察

目的　探讨丁螺环酮联合马普替林治疗抑郁症的效果。方法　随机将 6 4例抑郁症患者分成两组 ,分别给予丁螺环酮合并马普替林与单纯应用马普替林治疗 8周 ;以汉密顿抑郁量表 (HAMD)评定疗效 ,以不良反应症状量表 (TESS)评定副反应。结果　两组间HAMD于第 2、4、6、8周末减分率比较差异均有显著性(P <0 .0 1/P <0 .0 5 )。两组TESS评分各周差异均不明显。结论　丁螺环酮联用马普替林治疗抑郁症疗效优于单纯使用马普替林 ,且耐受性好     

丁螺环酮并用阿米替林治疗抑郁症

当前抑郁症治疗中仍存在两个主要问题尚未得到解决 :一是起效缓慢 ;二是药物副反应问题[1 ] 。故而在临床需要有新的增强抗抑郁药疗效 ,但又不增加抗抑郁药物副反应的方法。文献报道丁螺环酮对抗抑郁剂有增效作用[2 ] 。为此 ,我们在临床应用丁螺环酮并用阿米替林治疗抑郁症 ,并进行随机对照研究。观察其增强抗抑郁疗效。现报道如下。1　资料1 1　研究对象 :病例选自我院的心境障碍抑郁发作的住院病人。符合中国精神障碍分类与诊断标准第 3版心境障碍抑郁发作诊断标准[3] 。年龄 18～ 6 5岁。性别不限。汉密尔顿抑郁量表(HAMD) 2 1项总分…     

丁螺环酮对难治性抑郁症治疗的辅助作用

目的：观察西酞普兰合并丁螺环酮对难治性抑郁症的疗效和不良反应。方法：对42例难治性抑郁症患者，随机分为合用组(西酞普兰合并丁螺环酮，22例)和单用组(单用西酞普兰，20例)治疗6周。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效，以副反应量表(TESS)评定不良反应。结果：治疗第1、2、4、6周末两组间HAMD及HAMA评分比较，合用组低于单用组，差异有显著性；治疗6周末合用组显效率达72．7％，显著高于单用组的40％；两组间TESS评分同期比较差异均无显著性。结论：西酞普兰合并丁螺环酮对难治性抑郁症的疗效优于单用西酞普兰，且起效快，不良反应轻微。     

丁螺环酮与阿米替林治疗抑郁症的对照研究

评价丁螺环酮对抑郁症的疗效。用国产丁螺环酮中米替林随机双盲对照治疗３０例抑郁症。二者疗效相近，本螺环酮组副反应比阿米替林组少且轻微。丁螺环酮是一种安全有效的抗抑郁剂。     

舍曲林单用与合并不同剂量丁螺环酮治疗抑郁症患者的对照研究

目的:探讨不同剂量丁螺环酮对舍曲林抗抑郁的快速起效作用(ROAA)。方法:本研究是一项为期6周、不同剂量、随机、开放、对照的临床实验。90例抑郁症患者随机分为对照组30例(单一舍曲林)、舍曲林联合低剂量丁螺环酮(低剂量组)30例和舍曲林联合高剂量丁螺环酮(高剂量组)30例。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床总体印象表(CGI)等进行临床评估。观察治疗1周丁螺环酮是否使舍曲林的抗抑郁作用快速起效,并进一步评估第2、4、6周的临床差异。结果:以基线、治疗1周、治疗2周、治疗4周、治疗6周为观察点,3组被试无论HAMD总分还是HAMA总分,组间主效应不显著(P0.05),时间主效应均显著(P均0.01),组别×时间交互效应均显著(P均0.05)。治疗1周,对照组5例起效(16.7%),低剂量组8例起效(26.7%),高剂量组14例(46.7%)起效,3组间差异有统计学意义(χ2=6.67,P=0.036),事后检验对照组与高剂量组差异有统计学意义(P0.05)。3组间不良反应发生率差异无统计学意义(χ2=0.09,P0.05)。结论:高剂量丁螺环酮对舍曲林的抗抑郁作用有快速起效的作用,安全有效。     

舍曲林与阿米替林治疗抑郁症对照研究

目的：观察舍曲林治疗抑郁症的疗效和安全性。方法：口服舍曲林或阿米替林各治疗抑郁症36例，疗程6周，采用汉密尔顿抑郁量表(HAMD)和副反应量表(TESS)在治疗前和治疗后1、2、4、6周末评定药物疗效和副反应。结果：两组疗效无显著差异，HAMD总分及各因子分从疗后2周至6周均较治疗前显著降低，两组间则无显著差异。治疗结束时TESS评分舍曲林组显著低于阿米替林组。结论：舍曲林治疗抑郁症疗效好，副反应小，服用方便、安全，可首选使用。     

丁螺环酮在抑郁症治疗中的应用

目的：探讨丁螺环酮对抑郁症患者治疗的增效作用。方法：将78例抑郁症患者随机平分为两组。分别为单用文拉法辛(文拉法辛组)及文拉法辛合用丁螺环酮(合用组)，治疗4周。使用Hamilton抑郁量表(HAMD)，在治疗1、2及4周进行评定。以副反应量表(TESS)评定不良反应。结果：合用组在起效时间、明显改善时间均较文拉法辛组为快，HAMD分值下降较文拉法辛组更迅速。结论：丁螺环酮可作为抗抑郁药增效剂。     

丁螺环酮、百忧解加心理治疗对抑郁症的疗效对比研究

目的 探讨丁螺环酮合并百忧解加心理治疗对抑郁症的临床效果。方法随机将60例抑郁症患者分为药物对照组和合用研究组,经过8周的治疗。以汉密顿抑郁量表（HAMD）评定疗效,以不良反应症状量表（TESS）评定副反应。心理治疗采用认知疗法。结果HAMD疗前疗后和两组间2、4、6、8周评分均有显著性差异。两组TESS评分各周均没有统计学意义。药物加心理治疗组的疗效好于药物组,差异显著。结论丁螺环酮合并百忧解加心理治疗抑郁症的疗效好,起效快,治疗时间短,疗效持久不易复发。     

西肽普兰合并丁螺环酮治疗抑郁症的比较分析

目的比较西肽普兰合并丁螺环酮治疗抑郁症的临床疗效及不良反应。方法将64例抑郁症患者随机分为研究组和对照组,每组各32例,分别给予西肽普兰合并丁螺环酮和单用西肽普兰合并安慰剂,共治疗8周,采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、不良反应量表（TESS）评定疗效及不良反应。结果治疗后两组HAMD评分均有显著降低,差异有统计学意义（P〈0.05）,不良反应评分差异无统计学意义（P〉0.05）。结论西肽普兰合并丁螺环酮治疗抑郁症可增强总体疗效,且不增加不良反应。     

舍曲林与阿米替林治疗老年抑郁症对照研究

目的 :探索对老年抑郁症较理想的治疗药物。　方法 :采用舍曲林与阿米替林对 40例老年抑郁症进行为期 6周的双盲对照治疗。　结果 :舍曲林与阿米替林疗效相近 ,但舍曲林起效较快 ,平均 (8.7± 3.5 )天 ,口干、便秘、排尿困难及对心血管方面的副反应较小。　结论 :舍曲林是值得推荐的治疗老年抑郁症的较理想的药物     

阿米替林治疗氯氮平所致的遗尿症的对照分析

目的双盲对照研究阿米替林治疗氯氮平所致遗尿症的疗效.方法在住院患者中随机选取60例服用氯氮平(150～160mg/d)后出现遗尿副作用的精神病患者,随机分为阿米替林组(30例)和安慰剂(30例),早晚分别给服阿米替林25mg或安慰剂1粒治疗,3周为一疗程.结果阿米替林与安慰剂对照治疗氯氮平所致的遗尿症有显著性差异(P＜0.05).前者有效率达93.3%,起效快,无其它副作用.结论阿米替林可作为治疗氯氮平所致遗尿症的常规用药.     

A double-blind, multicentre study to assess the tolerability and efficacy of paroxetine compared with amitriptyline in the treatment of depressed patients in Australian general practice.

OBJECTIVE: This study compared the tolerability and efficacy of paroxetine and amitriptyline in the treatment of depression in general practice. METHODS: In this double-blind, multicentre study conducted in the general practice, patients with depression (Montgomery Asberg Depression Rating Scale [MADRS] score > or = 20) who were regarded as requiring antidepressant therapy were randomly assigned to receive paroxetine (20 mg, n = 184) or amitriptyline (50-100 mg, n = 191) once daily for 9 weeks. RESULTS: More patients completed treatment with paroxetine than with amitriptyline (71.1% vs 56.1%, p = 0.009). Depression rating scores (MADRS and Clinical Global Impression [CGI]) were improved with both agents, but at week 9, paroxetine achieved more favourable scores compared with amitriptyline on MADRS (p=0.019), CGI severity of depression (p=0.044), and CGI efficacy index (p = 0.038). CONCLUSIONS: Depressed patients treated in general practice respond more quickly and are more likely to complete the treatment regimen with paroxetine than with amitriptyline.     

氟西汀与阿米替林治疗老年抑郁症的疗效比较

目的：探讨氟西汀对老年抑郁症的临床疗效及副反应。方法：对80例老年抑郁症病人的随机分为氟西汀组（40例）和阿米替林组（40例）进行治疗研究，采用HAMD，TESS量表分别评定疗效及副反应。结果：氟西汀与阿米替林对老年抑郁症的疗效相似，氟西汀副反应较阿米替林少而轻微，结论：氟西汀较适合于老年抑郁症的治疗，患者有较好的依从性。     

Amitriptyline enhances the central component of physiological tremor

OBJECTIVES: Postural tremor is a regularly encountered side effect of amitriptyline which can be strong enough to cause discontinuation of therapy. The aim was to characterise amitriptyline induced tremor and to assess if the central or reflex component of physiological tremor was modulated by this drug. METHODS: The postural hand tremor was measured in 15 patients on a clinical rating scale, by power spectral analysis of accelerometer, forearm flexor, and extensor EMG before and after the beginning of amitriptyline treatment for major depression or chronic pain syndrome. A coherence analysis between flexor and extensor muscles on the same side was performed. RESULTS: There was a clinically visible increase in postural tremor in a third of these patients. The tremor amplitude measured by accelerometer total power increased in every patient under amitriptyline. The EMG synchronisation as reflected by significant peaks in the flexor or extensor spectrum generally occurring at higher frequencies (8-18 Hz) than the accelerometric tremor frequencies (6-11 Hz) did not change. The number of patients with a significant flexor-extensor coherence in the 7-15 Hz range increased significantly under amitriptyline, the frequency bands of significant coherence corresponded with the EMG frequencies, and both were independent of changes to the hand's resonant frequency by added inertia. CONCLUSIONS: An enhancement of postural tremor under amitriptyline is a common phenomenon although not always clinically apparent. The increase in EMG-EMG coherence indicates an increased common central drive to the motor units as its frequency is not influenced by peripheral resonance or reflex mechanisms. This is the first account of a drug induced enhancement of the central component of physiological tremor.     

Amitriptyline in migraine prophylaxis

In a controlled trial of amitriptyline hydrochloride in migraine prophylaxis, 100 patients received placebo for a four-week baseline period and then were randomized in double-blind fashion to therapy with amitriptyline (47 subjects) or placebo (53 subjects) for another four to eight weeks. Subjects received up to four 25-mg tablets of amitriptyline hydrochloride or identical placebo per day. Comparing the first and second four-week periods for each patient, the conditions of 55.3% of amitriptyline subjects as opposed to 34.0% of placebo subjects were greater than or equal to 50% improved and the difference between amitriptyline and placebo response rates was significant (P less than .05). Nondepressed subjects with severe migraine and depressed subjects with less severe migraine responded best to amitriptyline, whereas depressed subjects with severe migraine had little headache relief. Amitritryline is an effective antimigraine agent and the antimigraine effect seems relatively independent of antidepressant activity.     

Effect of amitriptyline on the thyrotropin response to thyrotropin-releasing hormone in endogenous depression

Patients with endogenous depression whose depressive episodes were clinically resolved after electroconvulsive therapy were divided into two groups: one in which patients remained well (n = 16) and another in which patients relapsed within 6 months (n = 11). Treatment with amitriptyline for 3 weeks did not affect the median thyrotropin (thyroid-stimulating hormone; TSH) response to thyrotropin-releasing hormone (TRH) in recovered patients, whereas that in relapsed patients was significantly enhanced. The data suggest that amitriptyline affects the TSH response to TRH differently in stably recovered and relapsed patients. If this effect is maintained beyond the 3-week period studied, treatment with amitriptyline will invalidate the predictive value of the TRH test.     

Progress in pharmacotherapy of borderline disorders. A double-blind study of amitriptyline, haloperidol, and placebo

In symptomatic patients with borderline disorder, we conducted a double-blind, placebo-controlled trial of haloperidol and amitriptyline hydrochloride to test the differential efficacy of medication against the affective and schizotypal symptoms that characterize the disorder. Sixty-one patients, diagnosed by the Diagnostic Interview for Borderline of Gunderson et al, completed randomized trials of haloperidol (n = 21), amitriptyline (n = 20), and placebo (n = 20). Medications were given in dose ranges of 4 to 16 mg for haloperidol (mean, 7.24 mg) and 100 to 175 mg for amitriptyline hydrochloride (mean, 147.62 mg) for five-week periods, with weekly self-rated and observer-rated measures of mood, schizotypal symptoms, and global functioning. Haloperidol was superior to both amitriptyline and placebo on a composite measure of overall symptom severity, with no difference between amitriptyline and placebo. Haloperidol produced significant improvement on a broad spectrum of symptom patterns, including depression, anxiety, hostility, paranoid ideation, and psychoticism. In contrast, amitriptyline was minimally effective, with small gains limited to some areas of depressive content. The magnitude of change tended to be modest and was more apparent in self-rated than observer-rated measures.     

A double blind comparison of viloxazine and amitryptyline in involutional and endogenous depression

Thirty-two hospitalized patients with either endogenous (n = 15) or involutional (n = 17) depression were entered into a double blind study to compare the effectiveness and acceptability of viloxazine with amitriptyline. The severity of the depression was assessed before starting treatment and at day 7, 14 and 28 using the Hamilton Rating Scale. Spontaneously reported side effects were recorded. Patients received viloxazine 50 mg three times a day during the first week followed by 100 mg three times a day during the next three weeks or amitriptyline 25 mg three times a day during the first week followed by 50 mg three times a day during the following three weeks. Viloxazine and amitriptyline were equally effective in endogenous depression, but viloxazine was significantly more effective than amitriptyline in patients with involutional depression. Nausea and vomiting were the main side effect of viloxazine during early treatment necessitating the withdrawal of two patients. Anticholinergic side effects were reported during amitryptyline treatment, but were absent in patients on viloxazine. It is concluded that viloxazine is an effective antidepressant and particularly useful in the treatment of involutional depression.