曲唑酮与米氮平治疗抑郁症的疗效比较

目的 比较曲唑酮与米氮平治疗抑郁症的疗效及安全性.方法 将65例抑郁症患者随机分为2组,研究组33例,给予曲唑酮50～200mg/d,对照组32例给予米氮平15～30mg/d,观察6周,采用汉密尔顿抑郁量表、汉密尔顿焦虑量表、临床总体印象量表、不良反应量表评定临床疗效及不良反应. 结果治疗6周末,2组各量表评分均较治疗前有显著改善(P＜0.01),研究组治疗1周末比对照组改善显著(P＜0.05).研究组显效率为75.8%,有效率为93.9%,对照组分别为75.0%和90.6%.2组不良反应均较轻微.结论 曲唑酮治疗抑郁症疗效显著,安全性高,依从性好.     

曲唑酮治疗失眠症22例

目的：观察曲唑酮治疗失眠症的疗效。方法：对符合CCMD 3失眠症诊断标准42例患者，随机分为治疗组22例，给予曲唑酮，老人从25 mg开始，睡前顿服，逐渐加量，最高为150 mg；对照组20例，每晚服用阿普唑仑0.8 mg。治疗4周，治疗前及治疗后用睡眠行为量表的入睡因素(SBO)、维持睡眠因素(SBM)及总体疗效评定，观察临床疗效。结果：治疗组总有效率90.9%，对照组总有效率85.0%，经χ2检验两组差异无显著性(P＞0.05)。结论：曲唑酮治疗失眠症疗效肯定，副作用少。     

米氮平与曲唑酮、马普替林治疗抑郁症对照研究

目的：评价米氮平与曲唑酮、马普替林治疗抑郁症的疗效及不良反应。方法：将符合《中国精神障碍分类与诊断标准》第3版诊断标准的抑郁症住院和门诊患者121例，随机平分为三组，分别给予米氮平和曲唑酮、马普替林治疗，疗程6周。用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、临床疗效总评量表的病情严重程度（CGI-S1）和不良反应量表（TESS），评定疗效和不良反应。结果：6周治疗后，3组总分均有显著下降，3组间疗效比较差异无统计学意义（P〉0、05）。结论：米氮平能更迅速的起效，对抑郁症的各个症状均有突出表现，是一种安全、有效的抗抑郁药。     

西肽普兰合并曲唑酮治疗老年抑郁症疗效观察

目的:探讨西肽普兰合并曲唑酮治疗老年抑郁症的临床疗效。方法:将74例老年抑郁症患者随机分为治疗组(西肽普兰服用剂量为20～40 mg.d-1合并曲唑酮服用剂量50～150 mg.d-1)及对照组(单用西肽普兰)各37例,疗程6周。分别于治疗后1、2、6周末用汉密尔顿抑郁量表,汉密尔顿焦虑量表评定疗效,以症状量表(TESS)评定治疗中出现的不良反应。结果:2组治疗后汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)总分比较差异有统计学意义(P<0.05),治疗组的不良反应比对照组重,主要表现有头昏、嗜睡,但患者均能耐受。结论:西肽普兰合并曲唑酮治疗抑郁症比对照组临床疗效更好。     

米氮平与帕罗西汀治疗抑郁症的疗效对比分析

目的比较米氮平与帕罗西汀治疗抑郁症的临床疗效与安全性。方法将71例符合CCMD-3诊断标准的抑郁症患者随机分成米氮平组(35例)和帕罗西汀组(36例),治疗6周,用汉密尔顿抑郁量表(HAMD)评定疗效,不良反应量表(TESS)评定不良反应。结果米氮平和帕罗西汀的有效率分别是82.86%和80.05%,二者比较差异无显著性(P>0.05)但米氮平起效快不良反应轻。结论米氮平是一种安全有效的第一代抗抑郁药。     

米氮平与帕罗西汀治疗抑郁症的疗效比较

［摘要］目的比较米氮平与帕罗汀治疗抑郁症的临床疗效与安全性。方法抑郁症患者71例，随机分成米氮平组35例和帕罗西汀组36例。米氮平组给予米氮平15～45 mg&#8226;d-1，帕罗西汀组给予帕罗西汀20～40 mg&#8226;d-1；两组均为每日顿服，共治疗6周，用汉密尔顿抑郁量表（HAMD）评定疗效，不良反应量表（TESS）评定不良反应。结果米氮平和帕罗西汀的有效率分别是82.86%和80.56%，二者差异无显著性（P＞0.05），但米氮平起效快，不良反应轻。结论米氮平是一种安全有效的新一代抗抑郁药。     

舍曲林与帕罗西汀治疗首发抑郁症的24周对照研究

目的：比较舍曲林与帕罗西汀治疗首发抑郁症的疗效和安全性。方法：将104例首发抑郁症患者随机分为舍曲林组61例,帕罗西汀组43例,共治疗24周,采用汉密尔顿抑郁量表（HAMD）评定临床疗效,不良反应量表（TESS）评定不良反应。结果：舍曲林组显效率为77%,帕罗西汀组显效率为73%,两组间比较无显著性差异。治疗前后HAMD评分比较两组均有显著性差异,两组间则无显著性差异。两组不良反应TESS评分比较在个别项目上有显著性差异。结论：舍曲林与帕罗西汀治疗首发抑郁症均有良好的疗效,但从不良反应的角度舍曲林可能更适合抑郁症的长期治疗。     

舍曲林与阿米替林治疗抑郁症的疗效比较

目的 比较舍曲林和阿米替林治疗抑郁症的疗效及不良反应。方法抑郁症患者60例，随机分为两组各30例。治疗组给予舍曲林20～40 mg·d^-1，qd， po；对照组给予阿米替林50～250 mg·d^-1，bid，po。疗程均为6周。用汉密尔顿抑郁量表(HAMD)、药物不良反应量表(TESS)进行评定。结果两组治疗抑郁症起效时间及疗效相近，治疗组和对照组有效率分别为76.7%， 70.0%(P＞0.05)；TESS评分分别为为(1.5± 1.2)，(3.4± 2.6)分( P＜0.01)。结论舍曲林治疗抑郁症与阿米替林疗效相似，但不良反应轻，用药方便。     

米氮平与帕罗西汀治疗抑郁症的对照研究

目的评价米氮平与帕罗西汀治疗抑郁症的疗效和不良反应。方法对85例患者采用随机法分为两组，分别给予米氮平与帕罗西汀，6周为一疗程，用汉密尔顿抑郁量表（HAMD）、临床疗效总评量表（CGI）、副反应量表（TESS）评定疗效和不良反应。结果米氮平与帕罗西汀治疗抑郁症的疗效接近，两者无显著性差异（P〉0．05），但米氮平的不良反应较少（P〈0．05）。结论米氮平治疗抑郁症有很好的疗效，且不良反应较少。     

国产帕罗西汀与阿米替林门诊治疗抑郁症患者的对照研究

目的比较国产帕罗西汀与阿米替林治疗门诊抑郁症的临床疗效和不良反应。方法对60例抑郁症患者随机分为两组,分别给予国产帕罗西汀和阿米替林治疗6周。采用汉密尔顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、临床疗效总评量表(CGI)评定疗效,用不良反应量表(TESS)评定不良反应。结果国产帕罗西汀组有效率为83.33%,与阿米替林组比较差异无显著性;但国产帕罗西汀的起效快,不良反应少。结论国产帕罗西汀治疗是一种安全有效的抗抑郁剂。     

米氮平与帕罗西汀治疗老年抑郁症的临床对照研究

目的比较米氮平和帕罗西汀治疗老年抑郁症的疗效及安全性。方法将70例住院老年抑郁症病人随机分为米氮平组和帕罗西汀组,各35例。米氮平起始剂量15mg·d-1,qn,1wk内加至30mg·d-1;帕罗西汀剂量为20mg·d-1,疗程均为6wk。以汉密尔顿抑郁量表(HAMD)和临床疗效总评量表(CGI)评定疗效,以抗抑郁药副反应量表(SERS)评定不良反应,分别在治疗前和治疗后2、4、6wk末评定一次。结果治疗前2组HAMD、病情严重程度(SI)评分无显著差异(P>0.05),治疗2、4、6wk末2组HAMD和SI评分与治疗前比较均显著下降(P<0.05或P<0.01)。治疗2wk末,HAMD和CGI评分2组间比较有非常显著差异(P<0.01);治疗4、6wk末,2组间HAMD、疗效总评(GI)和SI评分无显著差异(P>0.05),而疗效指数(EI)评分比较有显著差异(P<0.05)。治疗2、4、6wk末的SERS评分2组比较均有显著差异(P<0.05);帕罗西汀组躯体疲倦和性功能障碍发生多于米氮平组(P<0.05,P<0.01),而米氮平组发生嗜睡较多(P<0.05)。结论米氮平与帕罗西汀治疗老年抑郁症均有较好疗效,米氮平起效较快、不良反应较轻。     

A comparative, randomised, double-blind study of trazodone prolonged-release and paroxetine in the treatment of patients with major depressive disorder

OBJECTIVES: To evaluate the efficacy and safety of trazodone prolonged release compared with paroxetine in the treatment of patients with major depression. RESEARCH DESIGN AND METHODS: A total of 108 patients aged 20-68 years were enrolled in this multicentre, double-blind, double-dummy, randomised, paroxetine-controlled study. Each patient received 3 days single-blind placebo treatment followed by 6 weeks double-blind treatment with either trazodone prolonged release 150-450 mg/day (n = 55) or paroxetine 20-40 mg/day (n = 53). OUTCOME MEASURES: Efficacy was evaluated by the rate of patients responding to each treatment and considered to be in remission, and by mean changes from baseline in the Hamilton Depression Rating scale scores (HAM-D), Montgomery Asberg Depression Rating Scale scores (MADRS), and Clinical Global Impression (CGI)--Severity and Global Improvement scores. Time to onset of efficacy and safety were assessed. RESULTS: Trazodone and paroxetine were equally effective at reducing symptoms of depression and promoting remission. Onset of efficacy was slightly faster for patients treated with paroxetine. Overall, there were no significant differences between the groups at endpoint in efficacy measures, and in percentage of responders (> 85%) or patients in remission (> 65%). Sleep disorders (HAM-D subset) were significantly less evident for patients in the trazodone group at the end of the study (p < 0.05). Adverse drug reactions were reported by 35% of trazodone-treated patients (mainly of the nervous system) and 26% of paroxetine-treated patients (mainly gastrointestinal), although none was considered to be serious. CONCLUSIONS: This study showed that after a 6-week period trazodone and paroxetine are not different in reducing the symptoms of depression and, in many patients, in producing the remission of the illness. The known divergence in tolerability profile of the two medications, related to their differing pharmacological properties, was also confirmed. Trazodone may be of advantage in depressed patients with sleep difficulties.     

帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍临床观察

目的:观察帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍的临床疗效和药品不良反应。方法:伴有睡眠障碍的抑郁症患者150例随机分为对照组与观察组各75例。观察组给予帕罗西汀片20~40 mg·d-1联合奥氮平片10 mg·d-1治疗,对照组单纯给予帕罗西汀片20~40 mg·d-1治疗,疗程均为4周。观察两组患者睡眠潜伏期、总睡眠时间、早醒时间和觉醒次数等指标,比较两组疗效和汉密尔顿抑郁量表(HAMD)评分。结果:观察组患者的睡眠潜伏期、总睡眠时间、觉醒时间以及觉醒次数都明显优于对照组(P<0.05)。治疗后,两组HAMD评分均较治疗前明显降低(P<0.05),且观察组患者HAMD评分低于对照组患者(P<0.05)。观察组总有效率为94.7%,明显高于对照组的72.0%(P<0.05);观察组药品不良反应发生率也高于对照组(P<0.05)。结论:帕罗西汀联合奥氮平治疗抑郁症并发睡眠障碍起效快,能迅速有效改善患者睡眠障碍症状,临床疗效好。     

帕罗西汀治疗原发性失眠症

目的 :探讨帕罗西汀对原发性失眠症的疗效和副作用。方法 :帕罗西汀组 2 5例 ,男性 1 0例 ,女性 1 5例 ,年龄 (5 5±s1 2 )a,予帕罗西汀 1 0～ 3 0mg·d-1,po;阿普唑仑组 2 5例 ,男性 1 1例 ,女性 1 4例 ,年龄 (5 7± 1 3 )a,予阿普唑仑 0 .4～ 0 .8mg·d-1,po;安慰剂组 2 5例 ,男性 9例 ,女性 1 6例 ,年龄 (5 6± 1 2 )a,给予安慰剂 2片 ,po,qd。疗程均为 8wk ,治疗前及治疗wk 2 ,4,8末采用PSQI,TESS评定疗效及副作用。结果 :帕罗西汀组显效率 88% ,阿普唑仑组显效率 5 6% ,经Ridit分析 ,P <0 .0 1。帕罗西汀组常见副作用有口干、便秘、恶心等 ,不影响治疗。结论 :帕罗西汀治疗原发性失眠症疗效确切 ,副作用轻微     

帕罗西汀联合天王补心汤治疗伴焦虑症状抑郁症的效果观察

目的：探讨帕罗西汀联合中药天王补心汤治疗伴有焦虑症状抑郁症的临床效果及安全性。方法将98例伴有焦虑症状抑郁症患者随机分为研究组（n=49例）和对照组（n=49例）,研究组给予帕罗西汀联合天王补心汤治疗,对照组给予帕罗西汀治疗,治疗6周。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）及副反应量表（TESS）评定药物的疗效及不良反应。结果研究组和对照组的有效率分别为91.8%和77.6%,两组比较差异有统计学意义（P〈0.05）;两组治疗后HAMD和HAMA评分较治疗前均显著下降（P〈0.01）;研究组在治疗2、4、6周末HAMD和HAMA评分下降较对照组显著（P〈0.05）;研究组发生口干、恶心和失眠的不良反应明显少于对照组（P〈0.05）。结论帕罗西汀联合天王补心汤治疗伴有焦虑症状的抑郁症的效果比单用帕罗西汀更显著,能较快缓解患者的抑郁、焦虑症状,且不良反应少,安全性高。     

文拉法辛治疗持续性躯体形式疼痛障碍35例

目的：观察文拉法辛治疗持续性躯体形式疼痛障碍的疗效。方法： 将持续性躯体形式疼痛障碍初诊患者70例随机分为治疗组和对照组各35例，两组分别给予文拉法辛和阿米替林，均以25 mg，po，bid，根据病情渐增至50 mg，po，tid。分别在治疗后第4天和第1，2，4周评定疗效。结果：治疗组和对照组完全缓解分别为9，8例，明显缓解分别为13，10例，轻度缓解分别为8，10例，无效分别为5，7例；有效率分别为85.71%，80.00%；两组间差异无显著性(P＞0.05)。但治疗组口干、便秘、视物模糊、心动过速、嗜睡等不良反应明显比对照组少(P＜0.01)。结论： 文拉法辛对持续性躯体形式疼痛障碍疗效好，不良反应小，安全性高。     

A pilot study of the efficacy and safety of paroxetine augmented with risperidone, valproate, buspirone, trazodone, or thyroid hormone in adult Chinese patients with treatment-resistant major depression

To compare the efficacy and safety of augmenting paroxetine with risperidone, buspirone, valproate, trazodone, or thyroid hormone in patients with treatment-resistant depression (TRD), 225 patients with retrospectively and/or prospectively identified stage II TRD were randomly assigned to receive an 8-week treatment of paroxetine 20 mg/d augmented with risperidone 2 mg/d (n = 45), sodium valproate 600 mg/d (n = 39), buspirone 30 mg/d (n = 46), trazodone 100 mg/d (n = 47), or thyroid hormone 80 mg/d (n = 48). The primary outcome was the remission rate defined as the 17-item Hamilton Rating Scale for Depression score of 7 or less at the end of study. Secondary outcomes included remission rate based on the Self-rating Depression Scale score of 50 or less at the end of study, response rate based on 17-item Hamilton Rating Scale for Depression total score of 50% improvement or greater from baseline, and the change in scores of Clinical Global Impression-Improvement scale, the Short Form 36 Health Survey, and the Life Satisfaction Rating Scale. The remission rates were 26.7% for risperidone, 48.7% for valproate, 32.6% for buspirone, 42.6% for trazodone, and 37.5% for thyroid hormone. There was no statistical significance among treatment arms in remission rates, secondary outcome measures, and adverse events. Risperidone, valproate, buspirone, trazodone, or thyroid hormone augmentation to paroxetine 20 mg/d was effective and well tolerated in Chinese patients with TRD. Large-sample studies are warranted to support or refute these findings.     

帕罗西汀与丁螺环酮对照治疗广泛性焦虑79例

目的:比较帕罗西汀与丁螺环酮治疗广泛性焦虑的疗效和不良反应.方法:79例广泛性焦虑患者随机分成2组,治疗组39例,口服帕罗西汀20～40mg·d-1;对照组40例,口服丁螺环酮15～40mg·d-1,2组疗程均为4周,治疗前及治疗后1,2,4周末采用汉密尔顿焦虑量表(HAMA)、焦虑自评量表(SAS)、临床总体印象量表(CGI)及不良反应量表(TESS)评定临床疗效和不良反应.结果:治疗组显效率为66.7%,对照组显效率为70.0%,2组疗效比较差异无显著性(P＞0.05).药物不良反应与对照组比较差异无显著性(P＞0.05).结论:帕罗西汀治疗广泛性焦虑安全有效.     

A comparative,randomised, double-blind study of trazodone prolonged-release and paroxetine in the treatment of patients with major depressive disorder

ABSTRACT

Objectives: To evaluate the efficacy and safety of trazodone prolonged release compared with paroxetine in the treatment of patients with major depression.

Research design and methods: A total of 108 patients aged 20–68 years were enrolled in this multicentre, double-blind, double-dummy, randomised, paroxetine-controlled study. Each patient received 3 days single-blind placebo treatment followed by 6 weeks double-blind treatment with either trazodone prolonged release 150–450?mg/day (n = 55) or paroxetine 20–40?mg/day (n = 53).

Outcome measures: Efficacy was evaluated by the rate of patients responding to each treatment and considered to be in remission, and by mean changes from baseline in the Hamilton Depression Rating scale scores (HAM-D), Montgomery Asberg Depression Rating Scale scores (MADRS), and Clinical Global Impression (CGI) – Severity and Global Improvement scores. Time to onset of efficacy and safety were assessed.

Results: Trazodone and paroxetine were equally effective at reducing symptoms of depression and promoting remission. Onset of efficacy was slightly faster for patients treated with paroxetine. Overall, there were no significant differences between the groups at endpoint in efficacy measures, and in percentage of responders (> 85%) or patients in remission (> 65%). Sleep disorders (HAM-D subset) were significantly less evident for patients in the trazodone group at the end of the study (?p < 0.05). Adverse drug reactions were reported by 35% of trazodone-treated patients (mainly of the nervous system) and 26% of paroxetine-treated patients (mainly gastrointestinal), although none was considered to be serious.

Conclusions: This study showed that after a 6-week period trazodone and paroxetine are not different in reducing the symptoms of depression and, in many patients, in producing the remission of the illness. The known divergence in tolerability profile of the two medications, related to their differing pharmacological properties, was also confirmed. Trazodone may be of advantage in depressed patients with sleep difficulties.     

米氮平治疗抑郁症的临床疗效及安全性

目的:比较米氮平与阿米替林治疗抑郁症的疗效及安全性。方法:63例抑郁症患者随机分为2组,米氮平组32例给米氮平30mg,po,qn;阿米替林组31例采取从小量逐渐加药的方式,d1～d2 25mg,d3～d4 50mg,d5～d6 75mg,d7起100mg,po,bid,2组疗程均为6周。结果:米氮平组6周末显效率84.4％,痊愈率65.6％;阿米 替林组6周末显效率83.9％,痊愈率61.3％。2组疗效差异无显著性(P>0.05)。药物不良反应发生率米氮平明显低于阿米替林。结论:米氮平治疗抑郁症有效,未发现严重不良反应。