帕罗西汀与地西泮治疗广泛性焦虑症的临床对照研究

目的　评价帕罗西汀治疗广泛性焦虑症的临床疗效和副反应。方法　对 5 6例符合CCMD - 3诊断标准的广泛性焦虑症患者 ,分别应用帕罗西汀 (2 8例 )、地西泮 (2 8例 )进行治疗 ,疗程 4周。采用焦虑自评量表 (SAS)、Hamilton焦虑量表 (HAMA)和副反应量表 (TESS)评定疗效和副反应。结果　帕罗西汀与地西泮对广泛性焦虑症的疗效差异无显著性 (P >0 .0 5 )。治疗第 4周末两组SAS、HAMA以及HAMA因子分的减分比较差异有非常显著性 (P <0 .0 1)。副反应两药相似 ,帕罗西汀的主要副反应为口干、头痛、头晕和恶心。结论　帕罗西汀治疗广泛性焦虑症有效 ,副反应轻微     

坦度螺酮与氯硝西泮治疗广泛性焦虑症的对照研究

目的了解坦度螺酮对广泛性焦虑症的治疗效果及不良反应。方法将符合CCMD-3广泛性焦虑症诊断标准的82例患者随机分为坦度螺酮组（41例）和氯硝西泮组（41例），均治疗6周，采用汉密顿焦虑量表（HAMA）和临床疗效总体量表（CGI）以及不良反应量表（TESS）评定疗效和不良反应。结果坦度螺酮和氯硝西泮对广泛性焦虑症均有显著疗效，两组间差异无显著性（P〉0．05）。坦度螺酮组不良反应明显小于氯硝西泮组（P〈0．01）。结论坦度螺酮治疗广泛性焦虑症安全有效，不良反应小。     

坦度螺酮与氯硝西泮治疗广泛性焦虑症的临床分析

目的 评价坦度螺酮治疗广泛性焦虑症的临床疗效和不良反应。方法 对64例符合CCMD-3诊断标准的广泛性焦虑症患者，随机分为2组，分别为坦度螺酮（32例），氯硝西泮组（32例）进行治疗，疗程6周。采用焦虑自评量表（SAS）、Hamilton焦虑量表（HAMA）和副作用量表（TESS）评定疗效和不良反应。结果 坦度螺酮与氯硝西泮对广泛性焦虑症均有显著疗效。2组间疗效差异元统计学意义（P〉0．05），坦度螺酮不良反应明显少于氯硝西泮（P〈0．01）。结论 坦度螺酮治疗广泛性焦虑症安全有效，不良反应轻微。     

丁螺环酮与氯硝西泮治疗广泛性焦虑症的临床对照研究

目的　评价丁螺环酮治疗广泛性焦虑症的临床疗效和副反应。方法　对 2 88例符合CCMD 3诊断标准的广泛性焦虑症患者 ,随机分为两组 ,分别为丁螺环酮组 (14 4例 ) ,氯硝西泮组 (14 4例 )进行治疗 ,疗程 6周。采用焦虑自评量表 (SAS)、Hamilton焦虑量表 (HAMA)和副反应量表 (TESS)评定疗效和副反应。结果　丁螺环酮与氯硝西泮对广泛性焦虑症均有显著疗效。两组间疗效差异无显著性 ,(P >0 .0 5 ) ,丁螺环酮副反应明显少于氯硝西泮 (P <0 .0 1)。结论　丁螺环酮治疗广泛性焦虑症安全有效 ,副反应轻微。     

小剂量氯硝西泮联合帕罗西汀治疗抑郁症的疗效观察

目的小剂量氯硝西泮联合帕罗西汀治疗抑郁症的疗效。方法将60例焦虑症患者随机分为研究组和对照组,分别给予氯硝西泮、帕罗西汀治疗及帕罗西汀及安慰剂组治疗4周,用汉米尔顿抑郁量表（HAMD）、治愈率、副反应量表（TESS）评定疗效。结果研究组HAMD评分在治疗第7天明显低于对照组（P〈0.01）,第14天HAMD评分差异逐渐缩小,4周后2组无显著差异,不良反应发生率无明显差别。结论氯硝西泮联合帕罗西汀治疗起效快,抗抑郁效果明显。     

帕罗汀与阿普唑伦治疗广泛性焦虑性的对照研究

目的　比较帕罗西汀与阿普唑伦治疗广泛性焦虑症的疗效及安全性。方法　对68 例符合CCMD 3 诊断标准的广泛性焦虑症患者,随机分为帕罗西汀(A)组34 例和阿普唑伦(B)组34 例,分别给予帕罗西汀和阿普唑伦治疗6 周,采用Hamilton焦虑量表HAMA、焦虑自评量表SAS和副反应量表TESS评价疗效和副反应结果　帕罗西汀与阿普唑伦对广泛性焦虑症的疗效差异无显著性(P>0 05)。治疗第6 周末两组的SAS、HA MA及HAMA因子分的成分比较有非常显著性差异,二者的副反应相似。结论　帕罗西汀治疗广泛性焦虑症安全有效。     

万拉法新与丁螺环酮治疗广泛性焦虑症的对照分析

目的评价万拉法新治疗广泛性焦虑症的临床疗效和副反应。方法将76例符合CCMD-3诊断标准的广泛性焦虑症患者,随机分为两组,分别应用万拉法新（38例）、丁螺环酮（38例）进行对照治疗,疗程6周。采用焦虑自评量表（SAS）、Hamilton焦虑量表（HAMA）和副反应量表（TESS）评定疗效和副反应。结果万拉法新与丁螺环酮对广泛性焦虑症均有显著疗效,两组间疗效差异无显著性（P〉0．05）。万拉法新副反应明显少于丁螺环酮（P〈0．01）。结论万拉法新治疗广泛性焦虑症安全有效,副反应少。     

万拉法新与氯硝安定治疗广泛性焦虑症的疗效比较

目的评价万拉法新治疗广泛性焦虑症的临床疗效和不良反应方法将76例符合CCMD-3诊断标准的广泛性焦虑症患者随机分为两组,分别应用万拉法新（38例）、氯硝安定（38例）进行对照治疗。疗程6周。采用焦虑自评量表（SAS）、Hamilton焦虑量表（HAMA）和不良反应量表（TESS）评定疗效和不良反应。结果万拉法新与氯硝安定对广泛性焦虑症均有显著疗效,两组间疗效无显著性差异（P〉0．05）,万拉法新不良反应明显少于氯硝安定（P〈0．01）。结论万拉法新治疗广泛性焦虑症安全有效,不良反应少。     

普萘洛尔对焦虑症的辅助治疗作用

目的：观察帕罗西汀联合普萘洛尔治疗焦虑症的临床疗效和不良反应。方法：205例广泛性焦虑患者随机分为研究组105例（帕罗西汀联合普萘洛尔治疗）,对照组100例（单用帕罗西汀治疗）,疗程6周。采用汉密尔顿焦虑量表（HAMA）、临床疗效总评量表（CGI）评定临床疗效;采用治疗中出现的症状量表（TESS）评定安全性。结果：研究组和对照组治疗总有效率分别为87.8%和75.5%,两组比较差异有统计学意义（P〈0.05）。研究组治疗2、4、6周时的HAMA减分率均高于对照组（P均〈0.01）。研究组头痛、心动过速、震颤等不良反应均较对照组少而轻。结论：帕罗西汀联合普萘洛尔治疗广泛性焦虑症具有良好的疗效和安全性,且优于单用帕罗西汀。     

西酞普兰治疗广泛性焦虑症的对照研究

目的：探讨西酞普兰对广泛性焦虑症的治疗效果及不良反应。方法：将64例广泛性焦虑症患者随机分为西酞普兰组（32例）和氯硝西泮组（32例）,治疗4周。采用焦虑自评量表（SAS）、Hamilton焦虑量表（HAMA）和副反应量表（TESS）评定疗效及不良反应。结果：西酞普兰与氯硝西泮对广泛性焦虑症均有显著疗效,两组间差异无显著性。西酞普兰组不良反应明显小于氯硝西泮组。结论：西酞普兰治疗广泛性焦虑症安全有效,不良反应小。     

丙戊酸镁对广泛性焦虑的辅助治疗作用

目的：观察帕罗西汀联合丙戊酸镁治疗广泛性焦虑的疗效。方法：将60例广泛性焦虑患者随机分为两组,分别接受帕罗西汀联合丙戊酸镁（合用组）和帕罗西汀（单用组）治疗。疗程4周。分别于治疗前和治疗第1、2、4周末以汉密尔顿焦虑量表（HAMA）、临床疗效总评量表（CGI）评定疗效,治疗中出现的症状量表（TESS）评定药物不良反应。结果：治疗4周末,合用组HAMA评分显著低于单用组;合用组显效率显著高于单用组;两组不良反应均轻,发生率相仿。结论：帕罗西汀联合丙戊酸镁治疗广泛性焦虑有良好的疗效。     

帕罗西汀治疗海洛因领带者焦虑抑郁的研究

目的:了解帕罗西汀治疗海洛因依赖者焦虑抑郁的疗效与不良反应.方法:对海洛因依赖者伴发焦虑和抑郁的患者.在治疗前,治疗后,1,2,4和6周末分别以Hamilton焦虑量表(HAMA),Hamilton抑郁量表(HAMD),不良反应症状量表(TESS)及临床总体印 量表(CGI)评定.结果:帕罗西汀对海洛因依赖者伴发的焦虑抑郁症状有良好疗效,不良反应以口干,便秘,恶心,头昏等多见.结论:帕罗西汀能有效地缓解海洛因依赖者焦虑抑郁情绪.     

文拉法辛治疗广泛性焦虑对照观察

目的:比较文拉法辛与帕罗西汀治疗广泛性焦虑的临床疗效及不良反应。方法:将60例广泛性焦虑患者随机分为文拉法辛组(30例)及帕罗西汀组(30例),疗程8周。用焦虑自评量表(SAS)、汉密尔顿焦虑量表(HAMA)和治疗中出现的症状量表(TESS)评定疗效和不良反应。结果:治疗第2周末文拉法辛组SAS、HAMA总分与治疗前相比下降较帕罗西汀组更明显(P均<0.05)。治疗第2、4周末,文拉法辛组有效率分别为20%和56%,帕罗西汀组分别为3%和26%,组间差异均有显著性(P均<0.05);治疗第6周末,文拉法辛组治愈率为50%,帕罗西汀组为23%,组间差异有显著性(P<0.05);而两组间有效率差异无显著性(P>0.05)。结论:文拉法辛治疗广泛性焦虑安全有效,不良反应少。     

帕罗西汀与氯米帕明治疗难治性强迫症对照研究

目的：观察帕罗西汀和氯米帕明对难治性强迫症的疗效和不良反应。方法：对难治性强迫症患者60例,随机分为两组,分别用帕罗西汀和氯米帕明治疗8周。采用强迫症量表（Y-BOCS）和副反应量表（TESS）评价疗效及不良反应。结果：两药的总体疗效相仿。帕罗西汀对强迫行为疗效较好,不良反应小,尤其是心血管系统及抗胆碱能不良反应少。结论：帕罗西汀尤适用于以强迫行为为主的难治性强迫症患者。     

Paroxetine: current status in psychiatry

Paroxetine is a selective serotonin reuptake inhibitor (SSRI) with antidepressant and anxiolytic properties. It is commercially available in both an immediate-release (paroxetine) and a controlled-release formulation (paroxetine CR). The latter product was developed to improve gastrointestinal tolerability. Paroxetine is the most potent inhibitor of the reuptake of serotonin among the available SSRIs. It has approved indications for the treatment of major depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, post-traumatic stress disorder and social phobia in adults. Paroxetine CR is approved for the treatment of major depression, social anxiety disorder, panic disorder and premenstrual dysphoric disorder in adults. While the overall efficacy of paroxetine appears to be comparable with other SSRIs in the treatment of major depression, it is approved for use in a wider variety of anxiety disorders than any other antidepressant. Long-term data suggest that paroxetine is effective in preventing relapse or recurrence of depression for up to 1 year. Limited data show that paroxetine maintains a therapeutic response over 1 year in obsessive-compulsive disorder and up to 6 months in panic disorder. The side-effect profile of paroxetine is largely similar to that of the other SSRIs, although paroxetine tends to be more sedating and constipating in some patients, perhaps due to its anticholinergic activity. The potential for discontinuation syndrome and weight gain appears to be slightly higher with paroxetine than with other SSRIs. This review focuses on the immediate release and controlled-release formulations of paroxetine. It summarizes the efficacy and tolerability data for both formulations, with a particular emphasis on paroxetine CR which was introduced in 2002. It also discusses emerging evidence in other clinical areas and recent data that have led to modifications in the safety profile of paroxetine.     

Efficacy and tolerability of controlled-release and immediate-release paroxetine in the treatment of depression

BACKGROUND: Antidepressant efficacy may be compromised by early discontinuation of treatment secondary to common, treatment-emergent side effects, including nausea, agitation, and somnolence. Paroxetine controlled-release (CR) was developed to improve general tolerability and, in particular, gastrointestinal tolerability. OBJECTIVE: To determine the antidepressant efficacy and tolerability of paroxetine CR in adult patients 18 to 65 years of age with DSM-IV major depressive disorder. METHOD: Paroxetine CR (25-62.5 mg/day; N = 212) and paroxetine immediate-release (IR; 20-50 mg/day; N = 217) were compared with placebo (N = 211) in the pooled dataset from 2 identical, double-blind, 12-week clinical trials. RESULTS: Both paroxetine CR and paroxetine IR exhibited efficacy in major depressive disorder as assessed by the reduction in 17-item Hamilton Rating Scale for Depression total score compared with placebo. Moreover, depressed mood and psychic anxiety symptoms improved as early as treatment week 1 in the paroxetine CR group compared with the placebo group. After 6 weeks of treatment, response and remission rates were 41.5% and 20.5% for placebo, 52.8% and 29.6% for paroxetine IR, and 58.9% and 34.4% for paroxetine CR, respectively. After 12 weeks of treatment, response and remission rates were 61.2% and 44.0% for placebo, 72.9% and 52.5% for paroxetine IR, and 73.7% and 56.2% for paroxetine CR, respectively. Rates of nausea were significantly lower for paroxetine CR (14%) than for paroxetine IR (23%; p < or = .05) during week 1. Rates of dropout due to adverse events were comparable between paroxetine CR and placebo, while significantly (p = .0008) more patients treated with paroxetine IR withdrew from the study prematurely compared with those treated with placebo. CONCLUSION: Paroxetine CR is an effective and well-tolerated antidepressant exhibiting symptomatic improvement as early as week 1. Paroxetine CR is associated with low rates of early-onset nausea and dropout rates due to adverse events comparable to those of placebo. The clinical improvement seen with paroxetine CR, coupled with its favorable adverse event profile, suggests a benefit for therapeutic outcome with paroxetine CR.     

Remission of generalized anxiety disorder: a review of the paroxetine clinical trials database

OBJECTIVE: Paroxetine is a potent selective serotonin reuptake inhibitor with antidepressant and anxiolytic activity that is effective in the treatment of generalized anxiety disorder (GAD), improving the core symptoms of anxiety, worry, and tension. The majority of patients with GAD have chronic symptomatology and significant comorbid mood and anxiety disorders that often require ongoing pharmacotherapy. This article reviews the efficacy and tolerability of paroxetine in the short- and long-term treatment of GAD including remission data. DATA SOURCES: Data from more than 1800 outpatients with DSM-IV-defined GAD were analyzed from 3 short-term (8-week) studies and a longer (6-month) relapse prevention study. These studies were all randomized, double-blind, placebo-controlled trials of paroxetine. DATA SYNTHESIS: The results emphasize the benefit of paroxetine treatment in GAD, enabling a substantial proportion of patients to achieve clinical remission and preventing relapse. Long-term treatment with paroxetine also shows good tolerability with no evidence of weight gain. CONCLUSION: Given the high comorbidity of psychiatric depression and anxiety, the long-term efficacy and tolerability of paroxetine are important considerations when selecting a first-line therapy for patients with GAD.     

Inhibition of norepinephrine uptake in patients with major depression treated with paroxetine

OBJECTIVE: The study examined whether paroxetine inhibits the human norepinephrine transporter in addition to the human serotonin (5-HT) transporter in patients with major depressive disorder. METHOD: In an open-label, parallel-group, forced-titration study, 52 outpatients with DSM-IV major depressive disorder and a baseline Montgomery Asberg Depression Rating Scale score > or =20 were randomly assigned to treatment with paroxetine (to 60 mg/day) or desipramine (to 30 mg/day) in a 3-to-1 ratio, respectively. Norepinephrine and 5-HT transporter function were assayed by using human transporter transfected cells in the presence of serum collected at baseline and the end of each treatment week. Data from 36 patients were analyzed. RESULTS: Paroxetine decreased norepinephrine uptake to 73% of control (27% inhibition) at an average serum concentration of 100 ng/ml and 57% of control (43% inhibition) at 200 ng/ml. Uptake of 5-HT was decreased to less than 15% (greater than 85% inhibition) of control at these paroxetine concentrations. Desipramine decreased norepinephrine uptake to near maximal 15% of control (85% inhibition) at 100 ng/ml. Uptake of 5-HT was decreased to 82% of control (18% inhibition) at 100 ng/ml and 49% of control (51% inhibition) at 500 ng/ml. CONCLUSIONS: Paroxetine, currently classified as a selective 5-HT reuptake inhibitor, can act as a 5-HT/norepinephrine uptake inhibitor in vivo. The clinical significance of this action on norepinephrine uptake is currently unknown, but this action may contribute to the broad therapeutic efficacy of paroxetine in the treatment of depression, panic disorder, social anxiety disorder, posttraumatic stress disorder, and generalized anxiety disorder.