利培酮联合氟西汀对焦虑抑郁共病患者的治疗观察

目的观察利培酮联合氟西汀对焦虑抑郁共病的疗效和安全性。方法71例焦虑抑郁共病患者随机分为研究组(利培酮+氟西汀)38例、对照组(氟西汀)33例,治疗8周。于治疗前、治疗后每2周测评汉密尔顿抑郁量表(HAMD)24项、汉密尔顿焦虑量表(HAMA)、治疗中需处理的不良反应量表(TESS)。疗效评价以HAMD减分率为标准,不良反应以TESS评分为标准。结果两组HAMD、HAMA评分组间比较从第2周末开始差异有统计学意义(P<0.05、P<0.01),两组疗效比较差异有统计学意义(P<0.05),各时期TESS评分比较差异无统计学意义(P>0.05)。结论利培酮联合氟西汀治疗焦虑抑郁共病的疗效和安全性较好。     

利培酮联合氟西汀对焦虑抑郁共病患者的治序观察

目的 观察利培酮联合氟西汀对焦虑抑郁共病的疗效和安全性.方法 71例焦虑抑郁共病患者随机分为研究组(利培酮+氟西汀)38例、对照组(氟西汀)33例,治疗8周.于治疗前、治疗后每2周测评汉密尔顿抑郁量表(HAMD)24项、汉密尔顿焦虑量表(HAMA)、治疗中需处理的不良反应量表(TESS).疗效评价以HAMD减分率为标准,不良反应以TESS评分为标准.结果 两组HAMD、HAMA评分组间比较从第2周末开始差异有统计学意义(P＜0.05、P＜0.01),两组疗效比较差异有统计学意义(P＜0.05),各时期TESS评分比较差异无统计学意义(P＞0.05).结论 利培酮联合氟西汀治疗焦虑抑郁共病的疗效和安全性较好.     

米氮平与氟西汀治疗焦虑抑郁混合状态的疗效比较

［摘要］目的比较米氮平与氟西汀治疗焦虑抑郁混合状态的临床疗效及安全性。方法焦虑抑郁混合状态患者128例,随机分为治疗组65例,对照组63例,分别给予米氮平和氟西汀口服。米氮平初始剂量30 mg&#8226;d 1,最大不超过60 mg&#8226;d 1;氟西汀初始剂量20 mg&#8226;d 1,最大40 mg&#8226;d 1,均为每天1次,po,治疗周期为6周。采用汉密尔顿抑郁量表（HAMD）和不良反应量表（TESS）评定疗效及安全性。结果两组总体显效率基本相当,但治疗组治疗第1,2,4,6周HAMD总评分及焦虑/躯体化因子（A/S）评分明显低于对照组（ P＞0.05）。结论米氮平治疗焦虑抑郁混合状态安全有效,起效比氟西汀快。     

瑞波西汀治疗抑郁伴随焦虑症状的临床疗效

目的评价瑞波西汀治疗抑郁症伴随焦虑症状的有效性。方法采用随机、双盲、双模拟、氟西汀平行对照、多中心临床研究的方法。入组汉密尔顿抑郁量表(HAMD)17项≥18分且汉密尔顿焦虑量表(HAMA)≥14分的抑郁伴焦虑患者共137例(意向性治疗数据集,ITT集),分为试验组67例和对照组70例;完成试验132例(符合方案数据集,PP集),试验组64例,对照组68例。试验组每天服瑞波西汀8 mg,对照组每天服氟西汀20 mg。治疗时间为6 wk,在基线及治疗1、2、46、wk时评定HAMA、HAMD量表。结果根据PP集,治疗6 wk后,试验组和对照组HAMA减分值分别为(16.25±6.16)和(14.29±7.45)(P<0.05);治疗6 wk后,2组HAMD总分及因子分值变化在2组间无明显差异;2组不良反应无明显差异。结论瑞波西汀治疗抑郁伴随焦虑症状的作用有一定的优势;患者对瑞波西汀的耐受性好。     

焦虑障碍和抑郁障碍共病的概述

综述了焦虑与抑郁的关系、焦虑障碍与抑郁障碍共病的概念、普遍性、临床特征和药物治疗、中医中药治疗及心理治疗。     

氟西汀治疗胃癌根治术后化疗患者焦虑、抑郁的临床分析

目的:评价氟西汀对胃癌根治术后化疗患者焦虑、抑郁的疗效。方法:选择72例胃癌患者,随机分为对照组36例和治疗组36例,均采用常规化疗方法,治疗组同时予以氟西汀20mg,每日1次,共8周。治疗前后采用焦虑自评量表(SAS)和抑郁自评量表(SDS)进行检测。全部患者进行症状自评量表(SCL-90)评分,并与中国常模进行比较。结果:胃癌患者SCL-90各因子评分与中国常模比较,躯体化、抑郁、焦虑、恐怖等因子评分明显升高(P<0.01)。治疗组第八周SDS(41.2±3.7)及SAS(34.6±5.8)分。评分明显低于治疗前(分别为55.2±5.8和57.2±4.3)分。而对照组治疗第八周与治疗前比较差异无显著性(P>0.05);两组治疗后比较治疗组SAS评分和SDS评分均显著低于对照组(P<0.05)。结论:氟西汀对胃癌根治术后化疗患者抑郁、焦虑症状疗效显著。     

米氮平治疗焦虑抑郁障碍共病的疗效及安全性评价

目的探讨米氮平治疗焦虑抑郁障碍共病的临床疗效。方法选取我院2012年8月至2013年11月收治的86例焦虑抑郁障碍共病患者,将其随机分为观察组和对照组,每组各43例,观察组采用米氮平治疗,对照组采用文拉法辛治疗,比较两组患者治疗前及治疗6周后汉密顿抑郁量表(HAMD)评分、汉密顿焦虑量表(HAMA)评分及治疗后不良反应的发生情况。结果两组治疗6周后汉密顿抑郁量表(HAMD)评分、汉密顿焦虑量表(HAMA)评分较治疗前明显降低,且观察组治疗后与对照组比较有显著差异,P<0.01;且观察组治疗后不良反应发生率明显低于对照组,两组比较有统计学差异,P<0.05。结论米氮平治疗焦虑抑郁障碍共病疗效显著,安全性好,不良反应少。     

脑卒中患者伴发抑郁焦虑情绪的临床治疗

目的验证氟西汀对脑卒中患者伴发抑郁焦虑情绪的治疗作用。方法采用抑郁自评量表(SDS)、焦虑自评量表(SA S),先取伴抑郁、焦虑情绪的脑卒中患者70例,随机分为二组。治疗组:每日口服氟西汀20m g,共4周,于治疗后进行SDS、SA S测评,并与对照组进行对照。结果氟西汀治疗脑卒中患者伴发的抑郁、焦虑情绪有效率分别为81.25%和81.26%,明显高于对照组。结论氟西汀对脑卒中患者的抑郁、焦眠情绪均有明显治疗作用。     

艾司西酞普兰治疗脑卒中后抑郁焦虑共病的对照研究

目的对照研究脑卒中后抑郁焦虑共病患者采用艾司西酞普兰和帕罗西汀治疗效果。方法脑卒中后抑郁焦虑共病患者80例,随机分为研究组与对照组,各40例,其中对照组采用帕罗西汀治疗,而研究组则采用艾司西酞普兰治疗,对比分析两组患者临床效果。结果两组患者在治疗总有效率与不良反应发生率上差异无统计学意义（P〉0.05）;但两组患者在汉密尔顿焦虑量表（HAMA）与汉密尔顿抑郁量表（HAMD）评分上差异具有统计学意义（P〈0.05）,其中研究组明显优于对照组。结论对于脑卒中后抑郁焦虑共病患者采用艾司西酞普兰与帕罗西汀治疗,皆能取得比较良好的效果,并且安全性良好,但前者治疗可以更快更好的改善患者的抑郁与焦虑症状,值得借鉴。     

心脏早搏患者伴焦虑抑郁的治疗及其对生活质量的影响

目的 观察评价无器质性心脏早搏患者焦虑抑郁情况及抗抑郁药物治疗及其对患者生活质量的影响.方法 无器质性心脏早搏伴焦虑抑郁患者212例完全随机分为观察组和对照组,各106例,2组均给予美托洛尔,每次25～ 50 mg,2次/d.观察组同时给予氟西汀20～40 mg,1次/d(72例)或氟哌噻吨美利曲辛(34例),1片/次,早晨及中午各服1次,疗程2个月.治疗前后分别观察2组临床症状、心电图及焦虑自评量表(SAS)和抑郁自评量表(SDS)评分的变化,并采用“中国心血管病人生活质量评定问卷”进行生活质量评估.结果 观察组SAS、SDS评分治疗后与治疗前比较,差异有统计学意义[SAS:(39 ±9)分比(52±10)分;SDS:(39±10)分比(58 ±11)分;P＜0.01],而对照组治疗前后比较差异无统计学意义(P＞0.05);观察组治疗后的SAS、SDS评分与对照组治疗后比较,差异有统计学意义[SAS:(39±9)分比(53±10)分;SDS:(39±10)分比(58±9)分;P＜0.01].对照组治疗后心悸、胸闷、气促、胸痛症状的改善率分别为30.2％ (32/106)、42.6％(43/101)、46.0％( 23/50)、48.6％( 17/35),观察组改善率分别为84.9％( 90/106)、95.9％ (93/97)、96.4％ (53/55)、92.1％(35/38),2组比较差异均有统计学意义(均P＜0.01).观察组心脏早搏的临床疗效为84.0％(89/106),亦明显高于对照组的53.8％ (57/106).观察组“中国心血管病人生活质量评定问卷”的得分与对照组比较,差异有统计学意义(P＜0.01).结论 心脏早搏患者伴有焦虑抑郁障碍,应用抗焦虑抑郁药物治疗能有效缓解患者的临床症状、减少早搏的发生,同时能够改善患者的生活质量.     

利培酮合并氟西汀对无精神病性症状抑郁症的疗效比较

目的 观察利培酮合并氟西汀对无精神病性症状抑郁症的疗效和安全性.方法 147例无精神病性症状抑郁症患者随机分为研究组(利培酮 氟西汀)72例、对照组(氟西汀)75例,治疗8wk.于治疗前、治疗后每2 wk测评汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、治疗中需处理的不良反应量表(TESS).疗效评价以HAMD减分率为标准,不良反应以TESS评分为标准.结果 2组HAMD、HAMA评分组间比较从wk2末开始差异有统计学意义(P＜0.05),2组疗效比较差异有统计学意义(P＜0.05),各时期TESS评分组间比较差异无统计学意义(P＞0.05).结论 利培酮合并氟西汀治疗无精神病性症状抑郁症的疗效和安全性较好.     

Treatment Seeking among College Students with Comorbid Hazardous Drinking and Elevated Mood/Anxiety Symptoms

Background: Hazardous drinking is prevalent among college students and often comorbid with mood and/or anxiety disorders; however, these disorders frequently go untreated. Prior studies have found that individuals with comorbid hazardous drinking are more likely to seek treatment than those with an hazardous drinking alone. Objectives: The current study tested possible psychological and structural explanations to understand these treatment seeking behaviors. Methods: A sample of 222 students identified as hazardous drinkers (AUDIT ≥ 8) participated from September 2010 to April 2011. Behavioral measures designed to mimic actual treatment seeking and self-report measures were used to assess treatment seeking behaviors, and the influence of psychopathology and individual predictors on treatment interest. Results: Students were more interested in treatment for emotional problems than for alcohol problems. Further, treatment seeking interest was significantly higher among individuals with comorbid hazardous drinking. When provided a telephone offer for a free on-campus clinic appointment, no students were interested in receiving treatment for alcohol use problems, but some were interested in an appointment for emotional problems (n = 13). Of those students expressing interest on the phone, seven attended the clinic appointment. Logistic regression analyses revealed that students with anxiety, anxiety sensitivity, and depression were more likely to attend the clinic appointment. Conclusions/Importance: In sum, targeting mood and anxiety disorders may be a viable way to increase treatment seeking rates in hazardous drinking college students.     

文拉法辛和氟西汀治疗抑郁症患者的比较研究

目的 比较文拉法辛和氟西汀两种药物治疗抑郁症的疗效与安全性.方法 将符合<中国精神障碍分类与诊断标准(第三版)>(CCMD-3)抑郁症诊断标准的110例患者随机分为2组,文拉法辛组(n=30)和氟西汀组(n=80),疗效采用汉密尔顿抑郁量表(HAMD)评定,治疗中出现的安全性和不良反应由副反应量表(TESS)评定.结果 文拉法辛组治疗后总显效率为76.67%,总有效率为93.33%;氟西汀组治疗后总显效率为65.00%,总有效率为88.75%.两组比较,差异无统计学意义(P>0.05).结论 文拉法辛治疗抑郁症患者安全有效,不良反应与氟西汀无显著差异,疗效相似.     

拉莫三嗪对海洛因依赖者抑郁及焦虑障碍的治疗作用

目的:确定拉莫三嗪治疗海洛因依赖者抑郁、焦虑障碍的效果。方法:符合CCMD-2-R海洛因依赖者伴发焦虑症、抑郁性神经症诊断标准的72例病人随机分为2组,拉莫三嗪组及黛力新组(对照组),治疗前、治疗后1周末、3周末、5周末对两组病人进行HAMD及HAMA评分。结果:拉莫三嗪组的抗抑郁及焦虑作用于用药后第5周效果明显,用药后第1周及第3周其抗抑郁不如黛力新(P<0.05),而用药后第5周与黛力新无明显差异(P>0.05)。结论:拉莫三嗪有效地缓解海洛因依赖者焦虑抑郁障碍。     

Fluoxetine in Adolescents with Comorbid Major Depression and an Alcohol Use Disorder: A Five-Year Follow-Up Study

ABSTRACT

The goal of this five-year follow-up evaluation was to characterize the long-term (five-year) clinical course following the completion of an acute phase study with fluoxetine in comorbid adolescents. At the five-year follow-up evaluation, the group continued to demonstrate significantly fewer DSM criteria for an Alcohol Use Disorder (AUD) and fewer BDI depressive symptoms, and also consumed fewer standard drinks than they had demonstrated at the baseline of the acute phase study. Also, between the three- and five-year follow-up assessments, the level of self-reported depressive symptoms showed a significant decrease. Three of the 10 participants demonstrated Major Depressive Disorder (MDD) at the five-year follow-up assessment, but only one demonstrated Alcohol Dependence (AD), and none demonstrated Cannabis Dependence (CD). Eight of the 10 participants (80%) had demonstrated MDD at some time during the five-year follow-up study. The presence of a current AUD was significantly associated with the presence of a current MDD episode at both the one-year and the three-year follow-up evaluations. Six of the participants (60%) restarted SSRI medications at some point during the five-year follow-up period, but none were still taking SSRI antidepressants at the time of the 5-year assessment. Despite their substantial residual depression and alcohol use, a strong majority (8/10, 80%) of the subjects graduated from college during the five-year follow-up period. We conclude that the long-term (5-year) prognosis for the AUD, CD, and academic functioning of comorbid adolescents following acute phase treatment with SSRIs is surprisingly good. However, the long-term prognosis for their depression was surprisingly poor, and was worse than is typically seen among non-comorbid adolescents or adults.     

Thyroxine Augmentation of Fluoxetine Treatment for Resistant Depression in the Elderly: An Open Trial

Drug resistant depression is a confounding entity. More so in populations of elderly depressives where addition of lithium or antidepressant combinations are possibly hazardous. We present an open-trial of thyroxine in elderly patients diagnosed as suffering from resistant depression. Methods—Thyroxine 50 mcg/day was added to fluoxetine 20 mg/day in patients who did not respond to previous, non-SSRI, antidepressant treatment (6 weeks), nor to an additional 6 weeks of fluoxetine. Subjects—Subjects were diagnosed as suffering from major depression, according to DSM-III-R criteria. All had normal thyroid function tests (TSH and FT₄). There were 15 patients in our series: nine females, six males; mean age 72·1 years (±6·5). Results—Patients depression severity was graded using the Hamilton Depression Rating Scale at baseline (before thyroxine augmentation), and 4 weeks after initiation of treatment. Ten of 15 patients responded to thyroxine augmentation (HDRS<10), 3/15 showed no improvement of HDRS scores and two dropped out due to adverse effects: diarrhoea and tachycardia. Conclusions—Thyroxine augmentation of fluoxetine is effective in elderly subjects resistant to standard treatment, and is relatively safe.     

百忧解治疗脑卒中后抑郁的疗效观察

目的:探讨百忧解治疗脑卒中后抑郁的疗效。方法:94例脑卒中后抑郁患者分为治疗组(48例)和对照组(46例),同时应用常规脑血管病药物治疗,其中治疗组另加百忧解治疗。采用汉密尔顿(HAMD)评分和神经功能缺损程度评价疗效及康复情况。结果:治疗后治疗组HAMD量表减分率与对照组比较,差异有高度显著性(P<0.01),神经功能缺损程度评分降低值,治疗组明显高于对照组(P<0.01)。结论:百忧解能提高脑卒中后抑郁的疗效,改善患者的神经功能。     

噻奈普汀与氟西汀对照治疗抑郁症患者的系统评价

目的 系统评价噻奈普汀与氟西汀治疗抑郁症的疗效和安全性。方法 计算机检索中国期刊全文数据库、维普全文数据库、万方数据库、PubMed、Medline、EMBase中关于噻奈普汀与氟西汀治疗抑郁症的随机对照试验(RCT),对纳入的RCT采用Cochrane系统评价的方法进行评价,采用RevMan 5.0统计软件进行Meta分析。结果 共纳入5项研究,合计942例患者,meta分析结果显示,噻奈普汀组患者有效率[OR=1.25,95%CI(0.93,1.66),P=0.13]与氟西汀组比较差异无统计学意义;在不良反应发生率方面,2组比较差异有统计学意义[OR=0.53,95%CI(0.36~0.77),P<0.001]。结论 噻奈普汀与氟西汀治疗抑郁症疗效相当,不良反应少。但该结论尚需高质量、设计严谨的RCT进一步证实。