西酞普兰与马普替林治疗老年抑郁症的对照研究

目的比较西酞普兰与马普替林治疗老年抑郁症的疗效及安全性。方法将96例老年抑郁症住院患者随机分为两组,48例应用西酞普兰治疗,48例应用马普替林治疗,疗程均为8周。采用汉密尔顿抑郁量表（HAMD）、临床疗效总评定量表（CGI-SI）评定临床疗效,治疗中出现的不良反应量表（TESS）评定药物不良反应。结果西酞普兰与马普替林治疗老年抑郁症的疗效相当（P〉0.05）,但前者不良反应少（P〈0.05）。结论西酞普兰治疗老年抑郁症疗效显著,不良反应少,安全性高。     

西酞普兰与马普替林治疗抑郁症对照研究

目的：探讨西酞普兰治疗抑郁症的疗效和安全性。方法：将60例抑郁症患者随机分为西酞普兰组和马普替林组,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,采用副反应量表（TESS）评定不良反应。结果：西酞普兰组显效率为83．3％,马普替林组显效率为76．7％,两组差异无显著性。HAMA减分率西酞普兰组明显多于马普替林组,西酞普兰组不良反应较少而轻微。结论：西酞普兰治疗抑郁症见效快,疗效肯定,不良反应轻,依从性好。     

艾司西酞普兰治疗躯体形式障碍的临床疗效观察

目的探讨艾司西酞普兰治疗躯体形式障碍的临床疗效和安全性。方法将56例躯体形式障碍患者分为艾司西酞普兰和阿米替林组,并进行为期6周的治疗,采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评定临床疗效,采用治疗中出现的症状量表（TESS）评定不良反应。结果艾司西酞普兰与阿米替林治疗躯体形式障碍的疗效相当,但艾司西酞普兰起效快,不良反应少而轻。结论艾司西酞普兰治疗躯体形式障碍疗效好,值得推广。     

艾司西酞普兰治疗老年抑郁症的疗效

目的：探讨艾司西酞普兰治疗老年期抑郁症的疗效与安全性。方法：61例老年期抑郁症患者随机分为艾司西酞普兰组31例和舍曲林组30例治疗6周,采用汉密尔顿抑郁量表（HAMD）,临床大体印象量表（CGI）,治疗中出现的症状量表（TESS）评定疗效及不良反应。结果：治疗6周,两组各量表评分均较治疗前有显著改善（P〈0.01）,艾司西酞普兰组治疗1周比舍曲林组改善显著（P〈0.05）,提示西酞普兰组起效快,有效率93.5%,舍曲林组为90%,两组疗效相当（P〉0.05）,两组不良反应轻微,无需特殊处理。结论：艾司西酞普兰治疗老年期抑郁症疗效显著,安全性高,起效快,耐受性好。     

阿立哌唑对难治性抑郁症的增效作用

目的：探讨艾司西酞普兰联合阿立哌唑治疗难治性抑郁症的疗效及安全性。方法：62例难治性抑郁症患者随即分为合用组（艾司西酞普兰联合阿立哌唑）32例,单用组（单用艾司西酞普兰）30例,疗程8周。于治疗前和治疗2、4、8周分别用汉密尔顿抑郁量表（HAMD）及治疗中出现的症状量表（TESS）评定疗效与不良反应。结果：两组HAMD评分较治疗前均显著下降（P〈0.01）;两组不良反应差异无统计学意义（P均〉0.05）。结论：艾司西酞普兰联合阿立哌唑治疗难治性抑郁症疗效明显优于单用艾司西酞普兰,安全性较高。     

艾司西酞普兰与文拉法辛治疗抑郁症对照研究

目的：比较艾司西酞普兰与文拉法辛治疗抑郁症的疗效与安全性。方法：采用艾司西酞普兰与文拉法辛对48例抑郁症患者进行为期6周的双盲对照研究,用汉密尔顿抑郁量表（HAMD）、临床疗效总评量表（CGI）在治疗前及治疗1、2、4、6周评定疗效;用治疗中出现的症状量表（TESS）评定不良反应。结果：治疗6周后艾司西酞普兰组与文拉法辛组的有效率分别为87.50%和83.33%,两组差异无显著性。2药起效均较快,不良反应均较轻。结论：艾司西酞普兰与文拉法辛均是安全有效的抗抑郁药。     

艾司西酞普兰治疗老年抑郁症对照研究

目的:比较艾司西酞普兰与舍曲林治疗老年抑郁症的疗效和安全性. 方法:80例老年抑郁症患者随机分为艾司西酞普兰组和舍曲林组,每组40例,分别给予艾司西酞普兰和舍曲林治疗8周.采用蒙哥马利-阿斯伯格抑郁评价量表(MADRS),于治疗前及治疗1、2、4、6、8周评价疗效,并观察不良反应. 结果:治疗后两组MADRS评分均较治疗前明显下降;治疗各周的MADRS减分率以艾司西酞普兰组显著较高(P<0.05或P<0.01),起效更快,临床有效率和缓解率更高(P<0.05或P<0.01).两组不良反应均较少,艾司西酞普兰组不良反应发生率较舍曲林组更低(P<0.05). 结论:艾司西酞普兰和舍曲林治疗老年抑郁症疗效确切,服药依从性好.艾司西酞普兰起效快,不良反应少,适合老年抑郁症的一线用药.     

艾司西酞普兰片治疗抑郁症的Ⅱ期临床研究

目的评价艾司西酞普兰片治疗抑郁症的有效性和安全性。方法对符合《DSM—IV》抑郁症诊断标准的36例抑郁症患者进行艾司西酞普兰片和西酞普兰的对照研究，其中艾司西酞普兰片组18例（10mg／d），西酞普兰组18例（20mg／d），共治疗6周。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、临床总体评定量表（CGI）评定临床疗效，不良事件量表（AE）评定安全性。结果经6周治疗后，艾司西酞普兰组治疗总有效率为88．9％，西酞普兰组为75．0％，两组比较差异无显著性（P〉0．05）。两组HAMD、HAMA评分治疗前后差异有高度显著性（P〈0．001）。两组药物不良反应的发生率无显著性差异（P〉0．05），常见的不良反应有恶心、口干、头昏等。结论艾司西酞普兰片治疗抑郁症疗效好，不良反应少而轻，适合临床应用。     

西酞普兰治疗抑郁症临床观察

目的：评价西酞普兰治疗抑郁症的疗效和不良反应。方法：84例抑郁症患者，随机平分为两组，分别给予西酞普兰和阿米替林治疗，疗程8周。用汉密顿抑郁量表(HAMD)、临床疗效总评量表病情严重程度(CGI—SI)和副反应量表(TESS)评定疗效和不良反应结果：西酞普兰与阿米替林对抑郁症疗效相仿，但前者起效快，不良反应少于后者。结论：西酞普兰是一种安全有效的抗抑郁药。     

奥氮平治疗抑郁症的增效作用

目的：探讨小剂量奥氮平对艾司西酞普兰治疗无精神病性症状抑郁症的增效作用及安全性。方法：将60例无精神病性症状抑郁症患者随机分为艾司西酞普兰组及艾司西酞普兰合并奥氮平组,治疗6周。于治疗前、治疗1、2、6周末分别应用Hamilton抑郁量表（HAMD）及治疗中出现的症状量表（TESS）评定疗效及不良反应。结果：合用小剂量奥氮平组疗效显著好于单用艾司西酞普兰组,合用组治疗各周HAMD评分下降比单用组更为显著。两组TESS评分无显著差异。结论：合用小剂量奥氮平治疗抑郁症可提高疗效,且起效快。     

艾司西酞普兰治疗广泛性焦虑的疗效观察

目的探讨艾司西酞普兰治疗广泛性焦虑的疗效及安全性。方法将64例广泛性焦虑患者随机分为研究组(艾司西酞普兰组)与对照组(文拉法辛组)各32例,分别予艾司西酞普兰与文拉法新治疗,疗程均为6周。分别采用汉密尔顿焦虑量表(HAMA)、临床疗效总评量表-病情严重度(CGI-SI)、艾森贝格抗抑郁剂副反应量表(SERS)于治疗前及治疗第1,46周末进行评定。结果艾司西酞普兰组在治疗后各个时点2,,的HAMA总分、精神性症状分、躯体性症状分、CGI-SI评分均明显下降,与治疗前比较差异有统计学意义(P<0.05或P<0.01)。文拉法新组在治疗后第1周末躯体性症状分与治疗前比较差异有统计学意义(P<0.05),HAMA总分、精神性症状分、CGI-SI评分从治疗后第2周起明显下降,与治疗前比较差异有统计学意义(P均<0.01)。艾司西酞普兰组在治疗后各个时点躯体性症状分均低于对照组,两组比较差异均有统计学意义(P<0.05或P<0.01)。艾司西酞普兰组总有效率为84.28%,显效率为66.67%;与文拉法新组总有效率78.13%、显效率为53.33%比较差异均无统计学意义(P>0.05)。艾司西酞普兰组在治疗第1,周末SERS2总分与文拉法新组比较差异均有统计学意义(P<0.01)。治疗后6周末两组的SERS总分比较差异无统计学意义(P>0.05)。结论艾司西酞普兰治疗广泛性焦虑有良好疗效,起较更快,不良反应轻微。     

艾司西酞普兰治疗老年抑郁症的临床研究

目的探讨艾司西酞普兰治疗老年抑郁症的疗效及不良反应。方法将72例符合CCMD-3诊断标准的老年抑郁症患者采用随机分组的对照方法 ,分为艾司西酞普兰组和西酞普兰组,治疗时间均为12周。两组分别在治疗后第2、4、8、12周末,采用汉密尔顿抑郁量表(HAMD)、临床总体印象量表(CGI)评定疗效,治疗中出现的症状量表(TESS)评定不良反应。结果两组12周末HAMD减分率分别为(49.06±19.99)分、(28.88±16.75)分,两组间差异具有显著性意义(P0.01);两组12周末CGI减分率分别为(2.02±1.00)分、(3.01±1.12)分,两组间差异亦具有显著性意义(P0.01);TESS评分两组间无显著性差异(P0.05)。结论艾司西酞普兰是既有效又安全的新型抗抑郁药,适合对老年抑郁症的治疗。     

A double-blind, randomized, placebo-controlled trial of escitalopram in the treatment of pediatric depression

OBJECTIVE: Escitalopram is a selective serotonin reuptake inhibitor antidepressant indicated for use in adults. This trial examined the efficacy and safety of escitalopram in pediatric depression. METHOD: Patients (6-17 years old) with major depressive disorder were randomized to receive 8 weeks of double-blind flexibly dosed treatment with escitalopram (10-20 mg/day; n = 131) or placebo (n = 133). Randomization was not stratified by age. The primary efficacy measure was the mean change from baseline to endpoint in Children's Depression Rating Scale-Revised (CDRS-R) scores, using the last observation carried forward approach. RESULTS: A total of 82% of patients completed treatment. Escitalopram did not significantly improve CDRS-R scores compared to placebo at endpoint (least squares mean difference = -1.7, p = .31; last observation carried forward). In a post hoc analysis of adolescent (ages 12-17 years) completers, escitalopram significantly improved CDRS-R scores compared with placebo (least squares mean difference = -4.6, p = .047). Headache and abdominal pain were the only adverse events in >10% of patients in the escitalopram group. Discontinuation rates caused by adverse events were 1.5% for both groups. Potential suicide-related events were observed in one escitalopram- and two placebo-treated patients. There were no completed suicides. CONCLUSIONS: Although there were no significant differences between escitalopram and placebo in the total population, the data suggest that escitalopram may have beneficial effects in adolescent patients. Escitalopram appeared to be well tolerated.     

Escitalopram in the treatment of social anxiety disorder: analysis of efficacy for different clinical subgroups and symptom dimensions

Escitalopram has demonstrated efficacy for the acute treatment of social anxiety disorder (SAD) in two placebo-controlled trials and for long-term treatment in a relapse-prevention study. Social anxiety disorder is a heterogeneous disorder. This study questions whether this new selective serotonin reuptake inhibitor is effective across different subgroups of patients. Data from two randomised, placebo-controlled, 12-week escitalopram SAD trials were pooled. General linear models were used to determine the efficacy of escitalopram in different patient subgroups. Furthermore, a factor analysis of the primary efficacy scale, the Liebowitz Social Anxiety Scale (LSAS), was undertaken, and a determination made of whether treatment effects were similar for the different symptom dimensions. Escitalopram was effective in both younger and older patients, in male and female patients, and in patients with more and less severe social anxiety symptoms. The LSAS factor analysis showed six factors, which were differentially associated with different areas of disability. Escitalopram was significantly superior to placebo for all six symptom dimensions. The treatment effects of escitalopram were independent of gender, symptom severity and chronicity, and comorbid depressive symptoms. A six-factor model of social anxiety symptoms is supported by the distinctive association between these symptom dimensions and different areas of disability, but did not predict differential response to escitalopram.     

惊恐障碍在综合性医院识别现状和艾司西酞普兰治疗效果

目的:探讨目前综合性医院临床各科室对惊恐障碍识别的临床分析和艾司西酞普兰在综合医院治疗惊恐障碍的有效性和安全性。方法:以胸闷、心慌、濒死感等不适主诉至我院就诊排除躯体疾病后转诊至医学心理科就诊268例患者,分析其中确诊为惊恐障碍的179例患者在临床各科室的首诊诊断构成,以及对其中168例惊恐障碍患者随机分为艾司西酞普兰组和帕罗西汀组,疗程8周,并用惊恐相关症状量表(PASS)、汉密尔顿焦虑量表(HAMA)、不良反应评定量表(SERS)对患者治疗前后进行评估。结果:确诊为惊恐障碍的179例患者在临床各科室的首诊诊断包括惊恐障碍、广泛性焦虑、抑郁症、心脏神经官能症、癔症、其他疾病等,首诊时诊断为惊恐障碍的患者仅占9.5%。患者在治疗1周、治疗2周艾司西酞普兰组的HAMA、PASS分值均低于对照组,而在治疗4、6、8周,两组患者的HA-MA、PASS分值差异无统计学意义(P>0.05)。在治疗8周时,艾司西酞普兰组治愈率为65.4%,有效率为91.4%,帕罗西汀组分别为63.7%,91.3%。两组差异无统计学意义。在不良反应方面,两组差异无统计学意义。结论:综合医院临床各科室对惊恐障碍患者首诊时的识别率较低。艾司西酞普兰治疗惊恐障碍疗效肯定,安全性较高。     

Escitalopram in the treatment of panic disorder: a randomized, double-blind, placebo-controlled trial

BACKGROUND: Escitalopram, the therapeutically active isomer of the racemic selective serotonin reuptake inhibitor antidepressant citalopram, has shown significant anxiolytic effects in placebo-controlled clinical trials of social anxiety disorder, generalized anxiety disorder, and anxiety symptoms associated with major depression. This study evaluated the safety and efficacy of escitalopram in outpatients diagnosed with panic disorder. METHOD: Male and female outpatients between 18 and 80 years of age meeting DSM-IV criteria for panic disorder, with or without agoraphobia, were randomly assigned to 10 weeks of double-blind treatment with escitalopram, citalopram, or placebo in a study conducted from September 1999 to July 2001. The primary measure of efficacy was panic attack frequency at week 10 relative to baseline, as assessed by the Modified Sheehan Panic and Anticipatory Anxiety Scale. RESULTS: A total of 366 subjects (128 escitalopram patients, 119 citalopram patients, and 119 placebo patients) received at least 1 dose of double-blind treatment. The frequency of panic attacks was statistically significantly improved (p =.04), and the increase in percentage of patients with zero panic attacks reached borderline significance (p =.051), in the escitalopram-treated group relative to the placebo-treated group. Both escitalopram and citalopram statistically significantly reduced panic disorder symptoms and severity versus placebo at endpoint (p 相似文献   

Fixed-dose trial of the single isomer SSRI escitalopram in depressed outpatients

BACKGROUND: Escitalopram is the single isomer responsible for the serotonin reuptake inhibition produced by the racemic antidepressant citalopram. The present randomized, double-blind, placebo-controlled, fixed-dose multicenter trial was designed to evaluate the efficacy and tolerability of escitalopram in the treatment of major depressive disorder. METHOD: Outpatients with an ongoing DSM-IV major depressive episode (N = 491) were randomly assigned to placebo, escitalopram, 10 mg/day, escitalopram, 20 mg/day, or citalopram, 40 mg/day, and entered an 8-week double-blind treatment period following a 1-week single-blind placebo lead-in. Clinical response was evaluated by the Montgomery-Asberg Depression Rating Scale (MADRS), the 24-item Hamilton Rating Scale for Depression (HAM-D), the Clinical Global Impressions (CGI) scales, the Hamilton Rating Scale for Anxiety (HAM-A), and patient-rated quality-of-life scales. RESULTS: Escitalopram, at both doses, produced significant improvement at study endpoint relative to placebo on all measures of depression; significant separation of escitalopram from placebo was observed within I week of double-blind treatment. Citalopram treatment also significantly improved depressive symptomatology compared with placebo; however, escitalopram, 10 mg/day, was at least as effective as citalopram, 40 mg/day, at endpoint. Anxiety symptoms and quality of life were also significantly improved by escitalopram compared with placebo. The incidence of discontinuations due to adverse events for the escitalopram 10 mg/day group was not different from the placebo group (4.2% vs. 2.5%; p = .50), and not different for the escitalopram 20 mg/day group and the citalopram 40 mg/day group (10.4% vs. 8.8%; p = .83). CONCLUSION: Escitalopram, a single isomer SSRI, is well-tolerated and has demonstrated antidepressant efficacy at a dose of 10 mg/day.     

Escitalopram in the acute treatment of depressed patients aged 60 years or older.

OBJECTIVE: The present study examined the efficacy and tolerability of acute escitalopram treatment in depressed patients aged 60 years or older. METHODS: Patients aged > or =60 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depressive disorder were randomized to 12 weeks of double-blind, flexible-dose treatment with escitalopram (10-20 mg/day; N = 130) or placebo (N = 134). The prospectively defined primary efficacy end point was change from baseline to week 12 in Montgomery-Asberg Depression Rating Scale (MADRS) total score using the last observation carried forward approach. RESULTS: A total of 109 (81%) patients in the placebo group and 96 (74%) patients in the escitalopram group completed treatment. Mean age in both groups was approximately 68 years. Mean baseline MADRS scores were 28.4 and 29.4 for the placebo and escitalopram treatment groups, respectively. Escitalopram did not achieve statistical significance compared with placebo in change from baseline on the MADRS (least square mean difference: -1.34; last observation carried forward). Discontinuation rates resulting from adverse events were 6% for placebo and 11% for escitalopram. Treatment-emergent adverse events reported by >10% of patients in the escitalopram group were headache, nausea, diarrhea, and dry mouth. CONCLUSIONS: Escitalopram treatment was not significantly different from placebo treatment on the primary efficacy measure, change from baseline to week 12 in MADRS. In patients aged 60 years or older with major depression, acute escitalopram treatment appeared to be well tolerated.     

丁苯酞软胶囊联合艾司西酞普兰治疗卒中后抑郁的临床研究

分析丁苯酞软胶囊联合艾司西酞普兰对卒中后抑郁患者的临床疗效。方法根据PSD诊断标准,共纳入102例PSD患者。随机将PSD患者分为研究组(丁苯酞软胶囊联合艾司西酞普兰治疗组)和对照组(艾司西酞普兰治疗组)各51例,共治疗8周。治疗前及治疗后第8周末采用美国国立卫生院脑卒中量表(NIHSS)、Barthel指数、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)对患者神经功能缺损、日常生活能力、抑郁及焦虑程度进行评定,并观察治疗期间出现的不良反应。结果研究组临床有效率明显高于对照组(P<0.05);2组治疗后NIHSS评分、Barthel指数、HAMD和HAMA评分均明显改善(P<0.001),且研究组各评分明显优于对照组。2组不良反应均为轻中度,且发生率无明显差异(P>0.05)。结论丁苯酞软胶囊联合艾司西酞普兰可显著改善卒中后抑郁患者的神经功能缺损及焦虑、抑郁情绪,提高患者生活质量,且安全性良好。