氟西汀联合奥氮平治疗抑郁症临床观察

目的 探讨氟西汀联用奥氮平治疗抑郁症的疗效和不良反应.方法 将68例抑郁症患者随机分为两组,联合组在氟西汀（20mg/d）治疗的同时合用奥氮平（5～10mg/d）,氟西汀组仅用氟西汀（20mg/d）治疗,两组作8周的持续治疗观察,于入组前及入组后第1、2、4、8周末分别用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）进行评定.结果 在治疗第4天两组的HAMD平均总分的差异就有统计学意义（P〈0.05）,而且这种差异的显著性在每个访视期均存在.结论 氟西汀短期联用奥氮平治疗抑郁症是一种快速、有效、安全的治疗方法.     

氟西汀治疗脑卒中后抑郁症临床观察

目的探讨氟西汀治疗脑卒中后抑郁症的临床疗效。方法选取脑卒中患者80例全部通过临床CT或MRI证实,治疗组40例,Zung抑郁自评量表≥40分,或者GDS老年抑郁量表5～10分;对照组40例是有部分抑郁症状但尚未达到抑郁标准的脑卒中患者。2组患者均给予相似的脑血管病常规治疗,针对治疗组增加氟西汀（百忧解胶囊）,每天晨服1粒（20mg）,连服8周。结果治疗组患者的Zung量表和GDS量表评分,在服用氟西汀治疗后4周和8周抑郁症状均不同程度好转,第8周与第4周相比好转更加明显。分析表明优势半球卒中和多发性脑卒中患者抑郁症状更为突出,治疗后疗效也更加明显;ADL评分发现治疗组总体疗效好于对照组,第8周好于第4周,亚组分析仅提示优势半球脑卒中治疗组的ADL疗效明显好于对照组。结论氟西汀能够调节5-羟色胺浓度,改善抑郁症状,促进ADL功能恢复。     

氟西汀和帕罗西汀治疗抑郁症的对照观察

对氟西汀和帕罗西汀的疗效和副反应进行对照研究。1　对象与方法为符合 CCMD- 2 - R及 ICD- 10抑郁症诊断标准的门诊患者 ,汉密尔顿抑郁量表 (HAMD)评分 >18分 ,抑郁心境项评分 >2分 ;过去未服用过氟西汀或帕罗西汀 ;排除器质性疾病、妊娠或哺乳 ,以及有自杀、攻击行为、幻觉、     

西酞普兰与氟西汀治疗抑郁症的临床疗效观察

目的比较西酞普兰与氟西汀治疗抑郁症的疗效和安全性。方法将符合CCMD-3抑郁症诊断标准的患者随机分为两组,分别给予西酞普兰与氟西汀治疗;于治疗前及治疗后第1、2、4,6周末分别用汉密尔顿抑郁量表（HAMD）,临床疗效总评量表（CGI-SI）及治疗中出现的症状量表（TESS）评定;疗程6周。结果两组间HAMD评分无显著性差异（P〉0．05）,两组总有效率及不良反应亦无显著性差异（P〉0．05）。结论两药治疗抑郁症状的疗效及不良反应相当。     

米氮平与氟西汀治疗抑郁症对照观察

目的评价米氮平对抑郁症的疗效和不良反应。方法将门诊及住院患者70例随机分为2组,分别给予米氮平和氟西汀治疗,疗程6周。采用Hamilton抑郁量表（HAMD）、临床疗效总评量表病情严重程度（CGI-SI）及副反应量表（TESS）评价疗效和不良反应。结果米氮平在治疗1、2周末HAMD、CGI-SI评分显著低于氟西汀（P〈0.05）,治疗6周时2组疗效相似。2组不良反应均轻微。结论米氮平是一种安全有效的抗抑郁药,起效快。     

氟西汀并用氯氮平治疗抑郁症疗效观察

近年来,不少学者将非典型抗精神病药作为治疗抑郁症的增效剂,现对此进行研究,报告如下。     

国产氟西汀治疗抑郁症临床对照

为探讨国产氟西汀的临床疗效及副反应,笔者用国产氟西汀与阿米替林(均为常州第四制药厂生产)对抑郁症治疗的疗效、副反应进行了临床对照观察,报告如下。 资料与方法 一、病例选择 (1)对1996年4月～1997年11月在我院门诊治疗并有连续随访条件,符合CCMD—2—R抑郁症或双相情感障碍抑郁相的诊断标准;(2)HAMD≥18分;(3)排除躯体疾患。以符合上述标准的50例随机分为2     

不同剂量氟西汀治疗抑郁症对照研究

目的：比较不同剂量氟西汀治疗抑郁症的疗效及不良反应。方法：将50例抑郁症患者随机分为两组,分别给予氟西汀60mg／d(60mg组)及20mg/d(20mg组)治疗8周。以20mg／d治疗8周无显著疗效者,加量至60mg／d(加量组),继续治疗6周。采用汉密尔顿抑郁量表(HAMD)和副反应量表(TESS),每2周评定1次。结果：两组问显效率、不良反应差异均无显著性,但HAMD减分率在治疗第2、4周末差异有显著性。加量组8例,14周末HAMD评分及减分率与8周末比较差异均有显著性,4例显效。结论：氟西汀治疗抑郁症,较大剂量对部分患者更适宜。     

盐酸氟西汀治疗225例抑郁症临床观察

抑郁症是多病因疾病,目前治疗仍然棘手.其症状表现极为复杂且多变.近年推出的5羟色胺再摄取抑制剂(SSRIs)是一种安全、有效的药物,我们自1999年开始运用盐酸氟西汀(百忧解)动态观察治疗本病,现将225例治疗前后结果报告如下.     

氟西汀治疗老年抑郁症对照研究

本研究试用氟西汀治疗老年抑郁症 ,并以阿米替林为对照 ,现将结果报道如下。1　对象与方法病例选自 1 996～ 1 997年我院门诊或住院的病人 ,首次发病年龄≥ 65岁 ,符合 CCMD- 2 - R抑郁症诊断标准 ,汉密尔顿抑郁量表 ( HAMD)前 1 7项≥1 8分 ;排除有严重躯体疾病及药物过敏史者     

Early fluoxetine treatment of post-stroke depression

Objective: Poststroke depression is a frequent psychiatric complication after stroke that may have strong negative impact on rehabilitation therapy and functional recovery. This study was conducted to show the efficacy and safety of early treatment with the selective serotonin reuptake inhibitor fluoxetine in post-stroke depressed patients. Methods: This double-blind, randomized placebo-controlled study was of patients within two weeks after stroke. Moderate to severe depressed patients (determined by Hamilton Depression Scale (HDS) > 15, the Beck Depression Inventory (BDI) and the Clinical Global Impression (CGI) Scale) were randomized to receive either 20 mg/d fluoxetine or placebo for 3 months. Beside the psychiatric assessment, patients were evaluated by use of the Scandinavian Stroke Scale (SSS), the Mini-Mental-State-Examination (MMSE) and the Barthel-Index (BI). An open-label long-term follow up was done 18 months after the initial assessment. Results: 54 depressed patients of an inpatient population of 242 consecutive stroke patients aged 25 to 85 years entered the trial within the first two weeks post-stroke. 50 patients completed the trial per-protocol. The initial severity of depression was comparable in the two groups (mean baseline HDS score 32.8 in the fluoxetine vs. 30.3 in the placebo group), as were neurological symptom severity and demographic parameters. Significant improvement was seen in both groups within 4 weeks of treatment, whereas no advantages of fluoxetine could be observed at this time. This indicates a high degree of spontaneous recovery during early rehabilitation therapy. BDI scores of patients treated with fluoxetine further decreased until the follow-up at 12 weeks, whereas the scores increased again in the placebo group. This depressive relapse of the placebo patients after the end of most rehabilitation efforts was evident at a long-term follow-up 18 months after inclusion, when patients who had been treated with fluoxetine were significantly less depressed. No side effects of fluoxetine treatment were detected. Conclusions: The advantages of fluoxetine were obvious at the follow-up 18 months after inclusion, but could not be demonstrated within the first three months of controlled treatment. The multitude of therapeutic efforts that take place in the early phase of rehabilitation might have facilitated spontaneous recovery from depression and might have hindered benefits of antidepressant treatment to become obvious. Fluoxetine treatment was well tolerated and safe. Received: 5 February 2002, Received in revised form: 8 October 2002, Accepted: 28 October 2002 Correspondence to Stefan Fruehwald, MD     

Fluoxetine in child and adolescent depression: Acute and maintenance treatment

The objective was to present naturalistic 1-year follow-up information of 96 child and adolescent outpatients with major depressive disorder who had been randomized in an 8-week double-blind, placebo-controlled trial of fluoxetine. Subjects were children and adolescents, ages 8-18 years, who were entered in a randomized clinical trial of fluoxetine. Following the acute treatment trial, treatment was not controlled. At 6 months and 1 year, the subjects and parents were interviewed using the Kiddie Longitudinal Interval Follow-up Evaluation (K-LIFE) for course of depression. Eighty-seven of the 96 subjects were followed for 1 year. Of these, 74 (85%) recovered from the depressive episode during that time (47 on fluoxetine, 22 on no medication, and 5 on other antidepressants or lithium). Twenty-nine of the subjects (39%) who recovered had a recurrence of depression during the 1-year follow-up, with 55% of these occurring within 6 months. Results of this study are similar to adult studies, with respect to response and recovery of depressive episodes. Most patients (85%) recover from the episode within 1 year, but approximately 40% have a recurrence within 12 months, which is a higher recurrence rate than in adults. Recovery was associated with younger age, lower severity of depressive symptoms, higher family functioning, and fewer comorbid diagnoses. Recurrence, which occurs both on and off medication, was difficult to predict, as there was little clinical data associated with recurrence in this population. Depression and Anxiety 7:32–39, 1998. © 1998 Wiley-Liss, Inc.     

米氮平与氟西汀治疗抑郁症对照研究

目的：比较米氮平与氟西汀治疗抑郁症的临床疗效和安全性。方法：将60例抑郁症患者随机分为米氮平组和氟西汀组，分别给予米氮平和氟西汀治疗，疗程6周。采用汉密尔顿抑郁量表（HAMD）及治疗中出现的症状量表（TESS）评定疗效和不良反应。结果：米氮平组和氟西汀组显效率分别为80．0％和76．7％，两组疗效相仿。但治疗1周后，米氮平组的有效率高于氟西汀组。结论：米氮平是一种起效较快，安全、有效的抗抑郁药。     

阿立哌唑合并氟西汀治疗难治性抑郁症

目的：探讨阿立哌唑合并氟西汀治疗难治性抑郁症的效果。方法：将56例难治性抑郁症患者随机分成两组,分别给予阿立哌唑合并氟西汀（合用组）与单用氟西汀（单用组）治疗12周,以汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定临床疗效,以治疗中出现的症状量表（TESS）和相关检查评定不良反应。结果：治疗结束时两组HAMD和HAMA的评分均显着降低,以合用组疗效显著较好而快。结论：阿立哌唑合并氟西汀治疗难治性抑郁症的疗效优于单用氟西汀,且耐受性好。     

The efficacy of long-term psychodynamic psychotherapy,fluoxetine and their combination in the outpatient treatment of depression

Abstract

Objective: There are few randomized controlled trials examining the efficacy of long-term psychodynamic psychotherapy (LTPP) in depression treatment. LTPP was compared with fluoxetine treatment and their combination; Methods: 272 depressed patients (aged 26–34, 72% with a first episode of depression) were randomized to receive LTPP (one session/week), fluoxetine treatment (20–60 mg/day) or their combination for 24 months. Beck Depression Inventory (BDI) was the outcome measure. The psychotherapy was not manualized and the treatment took place under real-life conditions in an outpatient psychiatric clinic. Results: Intention-to-treat analyses indicated that all the treatments were associated with significant reductions in the BDI scores (mean reduction of 18.88 BDI points). Furthermore, LTPP and combination therapy were more effective in reducing BDI scores than fluoxetine alone (22.08 and 22.04 vs. 12.53 BDI points). Conclusions: LTPP, pharmacological treatment with fluoxetine and their combination are effective in reducing symptoms of patients with moderate depression. LTPP and combined treatment were more effective compared to fluoxetine alone. These findings have implications for patients with depression who may benefit from long-term psychotherapy or combined treatment, or for depressed patients who do not wish to take medications such as fluoxetine.     

Evaluation and treatment of rage in children and adolescents

Rage is characterized by an unpredictable and primitive display of violence that is out of proportion to the provoking event and often threatens serious self-injury or harm to others. New insight into the pathogenesis of unpredictable violent behavior has been gained largely as a result of neurochemical, neuropsychological and brain imaging studies. This article examines episodic rage from a neuropsychiatric perspective. Three cases illustrating the evaluation and treatment of rage in childhood and adolescence are presented.     

文拉法辛与氟西汀治疗抑郁症伴躯体症状对照研究

目的：比较文拉法辛与氟西汀治疗抑郁症伴躯体症状的临床疗效。方法：将77例患者随机分为两组,分别给予文拉法辛与氟西汀治疗6周,用汉密尔顿抑郁量表（HAMD）和治疗中出现的症状量表（TESS）作为评定指标分别于治疗前后评定疗效和不良反应。结果：文拉法辛组总有效率和临床治愈率分别为89.74%和66.67%,明显高于氟西汀组（分别为71.05%和39.47%）;两组HAMD评分治疗后均显著下降（P〈0.01）,文拉法辛组总分和焦虑/躯体化因子分,明显低于氟西汀组（P〈0.05）。结论：在治疗躯体症状方面,文拉法辛优于氟西汀。     

Refractory depression: the addition of lithium to fluoxetine or desipramine

We carried out an open clinical study with 60 consecutive patients suffering from major depression with melancholia who were resistant to anti-depressants. After at least 6 weeks of desipramine (DMI) or fluoxetine (FX) without improvement, lithium carbonate was added to the anti-depressant. Semistructured clinical interviews using the 7-point Clinical Global Impression Scale and 90-item Symptom Checklist were done at baseline and weeks 1, 6 and 14. Following the addition of lithium, more patients on FX improved within the first week than those on DMI. However, with FX, 6 relapses occurred during the 2 months of follow-up and none with DMI. The unified serotonergic and noradrenergic hypothesis for the antidepressant action could be relevant in drug-refractory depression and should be studied further.