神郁安改善抑郁症伴随症状的临床作用

目的:探讨神郁安对抑郁情绪、不良心理、焦虑等精神疾病伴随症状的改善作用。方法:将58例抑郁症病人随机分为2组,对照组(27例)口服盐酸氟西汀胶囊治疗,研究组(31例)口服盐酸氟西汀胶囊并于翳风穴、翳明穴、安眠穴贴上神郁安。用汉密尔顿抑郁量表(HAMD)(17项版本)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评定治疗效果。结果:治疗前,研究组和对照组HAMD、SDS、SAS评分差异无统计学意义(P0.05);治疗3周后两组HAMD、SDS、SAS评分均有显著差异(P0.01)。研究组和对照组的总有效率分别为90.32%和77.78%,研究组痊愈率和总有效率显著高于对照组(P0.05)。结论:通过口服盐酸氟西汀胶囊联合神郁安的穴位贴敷治疗能显著改善患者的抑郁症状。     

氟西汀干预女性癌症术后化学治疗患者焦虑、抑郁的疗效评价

目的 评价氟西汀治疗女性术后化学治疗癌症患者焦虑、抑郁的疗效.方法 选择58例女性癌症术后化学治疗患者,随机均分为对照组和治疗组各29例.两组均采用常规化学治疗,治疗组同时予以氟西汀胶囊20mg口服,每日1次,共8周.全部患者采用症状自评量表(SCL-90)评分,分别于治疗前、后采用焦虑自评量表(SAS)和抑郁自评量表(SDS)进行评定.结果 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).与治疗前比较,治疗组SDS和SAS评分均显著降低(P<0.05),而对照组则无显著性差异(P>0.05).治疗组治疗后SAS和SDS评分均显著低于对照组(P<0.05).治疗组仅见2例轻度口干、恶心反应.结论 氟西汀治疗女性癌症术后化学治疗患者抑郁、焦虑症状,效果显著,不良反应轻,耐受性良好.     

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。     

盐酸氟西汀治疗脑卒中后抑郁的临床效果观察

目的探讨盐酸氟西汀治疗脑卒中后抑郁的临床疗效。方法随机将2017年1月至2018年5月本院收治的116例脑卒中后抑郁患者分到观察组(n=58)和对照组(n=58),两组患者施以常规神经内科治疗及康复治疗,观察组患者在此治疗基础上加以盐酸氟西汀治疗,对照组患者在此基础上加以安慰剂治疗,采用抑郁自评量表(SDS量表)评价治疗前后两组患者的抑郁症状变化情况。结果治疗前,观察组及对照组患者的SDS量表评分分别为(67.72±6.46)分、(67.78±6.51)分,两组比较,P> 0.05。治疗后,观察组及对照组患者的SDS量表评分分别为(42.45±2.64)分、(52.18±3.34)分,两组比较,P <0.05。结论在脑卒中后抑郁患者施以盐酸氟西汀治疗,能有效改善患者的抑郁症状。     

盐酸氟西汀配合心理干预治疗2型糖尿病伴发情绪障碍32例的临床观察

目的探讨盐酸氟西汀配合心理干预对2型糖尿病伴发情绪障碍的临床疗效。方法选取符合标准的2型糖尿病患者64例,随机分为观察组和对照组,各32例。对照组只给予常规降糖药物,观察组同时给予盐酸氟西汀抗抑郁治疗和心理干预,12周后比较两组空腹血糖、果糖胺、糖化血红蛋白及焦虑、抑郁自评量表评分情况。结果治疗前后观察组在糖尿病生化指标及焦虑、抑郁评分方面均下降明显,与对照组相比差异有统计学意义（P〈0．05）。结论盐酸氟西汀配合心理干预治疗2型糖尿病伴发情绪障碍患者,可改善患者情绪,增加遵医行为,在降低血糖的同时,延缓并发症的发生,提高患者的生活质量。     

氟西汀对伴抑郁状态心血管疾病患者疗效观察

目的探讨氟西汀治疗伴抑郁状态心血管疾病患者的临床疗效及安全性。方法 84例心血管疾病伴抑郁状态患者,随机分为观察组和对照组,每组42例,对照组给予常规治疗,观察组在此基础上给予氟西汀治疗,观察两组治疗后抑郁症状改善情况。结果治疗后观察组总有效率97.62%,对照组总有效率83.33%,两组比较差异有统计学意义(P<0.05);与治疗前相比,两组汉密尔顿抑郁量表(HAMD)、焦虑自评量表(SAS)、抑郁自评量表(SDS)三个量表评分均显著降低(P<0.05),治疗后观察组评分均低于对照组,差异均有统计学意义(P<0.05);SCL-90评定中,两组躯体、抑郁、敌对等治疗前后比较,差异有统计学意义(P<0.05);观察组治疗过程中无严重不良反应及并发症发生。结论氟西汀治疗伴抑郁状态心血管疾病疗效显著,可有效改善患者抑郁情绪,提高患者的心功能,且不良反应发生率低,方法安全、可靠,值得临床推广应用。     

早期心理干预联合氟西汀治疗脑卒中后抑郁症的临床观察

目的:评价急性脑卒中后抑郁的发生情况,并观察早期心理干预联合氟西汀治疗脑卒中后抑郁症的疗效。方法:220例首发急性脑卒中患者用Hamilton抑郁量表、抑郁自评量表和社会支持量表进行抑郁症评价,并进行Logistic多元逐步回归分析。将确诊为抑郁症的118例患者随机分为对照组和心理干预联合氟西汀治疗组,2组均接受常规药物治疗,治疗组在对照组基础上同步进行心理干预联合氟西汀治疗。结果:脑卒中后抑郁的发生率为53.63%;病灶位于皮质和皮质前部的患者抑郁评分显著高于位于皮质下和皮质后部的患者;治疗后治疗组有效率为93.22%,显著高于对照组的61·01%(P<0·05)。结论:首发急性脑卒中的抑郁症发生率较高,其严重程度与病变部位有关。早期心理干预联合氟西汀治疗脑卒中后抑郁症明显有效。     

氟西汀对老年原发性高血压伴抑郁症患者血压影响的临床观察

目的评价盐酸氟西汀治疗原发性高血压伴焦虑抑郁症状患者的疗效。方法40例原发性轻中度老年原发性高血压伴焦虑抑郁症状患者,随机分为两组,治疗组及对照组,所有患者均给予常规抗高血压治疗,治疗组加用盐酸氟西汀8周,并评定两组有效降压程度及抑郁自评量表（SDS）得分情况。结果盐酸氟西汀治疗后抑郁症状及降压程度较对照组明显改善,与对照组比较差异具有显著性（P〈0．05）。结论对伴抑郁症的高血压病患者在常规降压治疗的基础上给予盐酸氟西汀治疗,能明显提高患者的降压效果和显著改善患者的精神况状。     

氟西汀治疗脑卒中伴发抑郁障碍的临床疗效观察

目的观察氟西汀治疗脑卒中伴发抑郁障碍的临床治疗效果。方法选择脑卒中伴发抑郁障碍(汉密顿抑郁量表评分≥20分)的患者68名，随机分成两组，对照组仅进行常规治疗，观察组在常规治疗的基础上加用氟西汀治疗，每2周采用汉密顿抑郁量表(HAMD)评定疗效一次，共观察8周。结果从第二周末两组患者汉密顿抑郁量表(HAMD)评分均开始减低，观察组汉密顿抑郁量表(HAMD)评分分值明显低于对照组。结论脑卒中伴发抑郁障碍的患者进行抗抑郁治疗是有效的、必要的。     

氟西汀联合阿立哌唑对抑郁症患者的治疗效果探讨

目的 探讨氟西汀联合阿立哌唑对抑郁症患者的治疗效果.方法 95例抑郁症患者,根据治疗方式的不同分为观察组(49例)和对照组(46例).观察组采用氟西汀联合阿立哌唑治疗,对照组采用氟西汀治疗.比较两组患者的疗效,睡眠质量,汉密尔顿抑郁量表(HAMD)及抑郁自评量表(SDS)评分、去甲肾上腺素(NE)及5-羟色胺(5-HT...     

Fluoxetine treatment of depressed patients with comorbid anxiety disorders

Major depression with comorbid anxiety disorder is associated with poor antidepressant outcome compared to major depression without comorbid anxiety disorder. The purpose of our study was to assess changes in severity of both depressive and anxiety symptoms in outpatients with major depression with comorbid anxiety disorder following fluoxetine treatment. We enrolled 123 outpatients (mean age 38.9 +/- 10.8 years; 49% women) with major depressive disorder accompanied by one or more current comorbid anxiety disorders in our study. Patients were treated openly with fluoxetine 20 mg/day for 8 weeks. Efficacy assessments included the 17-item Hamilton Rating Scale for Depression (HAM-D) and the patient-rated Symptom Questionnaire (SQ) Scales for Depression and Anxiety. The mood and anxiety disorder modules of the Structured Clinical Interview for DSM-III-R were administered at screen and endpoint. We used 'intent-to-treat' analysis in examining all patients assigned to treatment and completing the baseline visit. The mean number of comorbid anxiety disorders per patient was 1.5 +/- 0.68. The mean HAM-D-17 score and mean Clinical Global Impressions-Severity scores decreased significantly from baseline to endpoint (week 8) following fluoxetine treatment (p < 0.0001). There were significant decreases in all four SQ scale scores, from baseline to endpoint: depression, anxiety, somatic symptoms and anger-hostility (p < 0.0001). Fifty-three percent of patients (n = 65) were depression responders (i.e. > or = 50% decrease in HAM-D-17 score at endpoint) and 46% (n = 57) were remitters (HAM-D-17 < or = 7 at endpoint). Patients with panic disorder had significantly higher baseline HAM-D-17 scores compared to those without panic disorder (p < 0.01). Patients with comorbid obsessive-compulsive disorder (OCD) were significantly less likely to be responders to fluoxetine at endpoint (> or = 50% decrease in HAM-D-17) and to be remitters (HAM-D-17 score of s 7 at endpoint) compared to patients without comorbid OCD (p < 0.01). Of the 41 patients on whom endpoint Structured Clinical Interview for DSM-III-R modules for anxiety disorders were available, 49% (n = 20) no longer met criteria for one or more of their anxiety disorder diagnoses at endpoint. Our preliminary findings suggest that fluoxetine is effective in treating outpatients with major depression with comorbid anxiety disorders, with a significant effect on both depression and anxiety symptoms. Further double-blind, placebo-controlled trials are required in larger samples to confirm our findings.     

Venlafaxine compared with fluoxetine in outpatients with depression and concomitant anxiety

The aim of this double-blind study was to compare the efficacy and safety of venlafaxine vs. fluoxetine in the treatment of patients with depression and anxiety. A total of 146 moderately depressed patients with associated anxiety were randomized to receive 75 mg/d venlafaxine or 20 mg/d fluoxetine for 12 wk. Dose increases were permitted after 2 wk of treatment, to 150 mg/d venlafaxine and 40 mg/d fluoxetine, to optimize response. At the final visit, a statistically significantly greater efficacy of venlafaxine over fluoxetine was observed on depressive symptoms and concomitant anxiety, and 75.0 and 50.7% of patients administered venlafaxine and fluoxetine, respectively, showed an overall response. A sustained response (for at least 2 wk), present at the end of the study was achieved in 57.8 and 43.3% of patients in the venlafaxine and fluoxetine groups, respectively, and at the final visit, 59.4 and 40.3% of patients, respectively, were in remission (virtually asymptomatic). Dose increases were required by a greater percentage of patients in the fluoxetine group (52.9%), than in the venlafaxine group (37.1%), and in those patients whose dose was increased, a higher efficacy was again observed with venlafaxine. Venlafaxine and fluoxetine were well tolerated, with the most frequently experienced adverse events being nausea and headache. Fewer patients in the venlafaxine group than in the fluoxetine group reported at least one adverse event (55.7 and 67.1% patients, respectively). Venlafaxine therefore proved to be significantly more effective than fluoxetine in improving depressive symptoms and concomitant anxiety.     

百忧解治疗脑卒中后抑郁情绪 认知功能及神经功能缺损程度的疗效观察

目的　探讨百忧解 (fluoxetinehydrochloride;prozac)治疗脑卒中后抑郁患者抑郁情绪、认知功能及神经功能缺损程度的疗效。方法　选择 82例急性脑卒中患者 ,经DSM Ⅳ诊断脑卒中后抑郁 ,评定百忧解治疗前后汉密尔顿抑郁量表得分、认知功能及神经功能缺损程度的变化。结果　脑卒中后抑郁患者存在认知功能下降及神经功能缺损程度加重 ;百忧解可改善脑卒中后抑郁患者的抑郁情绪、认知功能及神经功能缺损程度。结论　百忧解适用于治疗脑卒中后抑郁患者     

Predictors of an acute antidepressant response to fluoxetine and sertraline.

Sertraline and fluoxetine have different pharmacologic and pharmacokinetic profiles which may be of clinical relevance in the determination of response in different subtypes of depression. A randomized, double-blind, 6-week study comparing sertraline (50-100 mg/day) with fluoxetine (20-40 mg/day) in 286 outpatients with major depression, who had demonstrated comparable efficacy and tolerability for the two drugs, was analysed by subgroups of patients at baseline with melancholia, severe depression, single depressive episode, multiple depressive episodes, high anxiety, low anxiety, psychomotor retardation and psychomotor agitation. Multiple logistic regression with regressors including treatment-by-subgroup variables revealed that, within certain subgroups, the efficacy might differ substantially from that of the whole treatment group. However, the only treatment-by-subgroup interaction term that was significant was anxiety (P < 0.05). There was no evidence of interaction in single or recurrent episode subgroups, and these were not included in subsequent analyses. Subsequent two-sample statistical comparison tests of response (i.e. Hamilton Depression Scale reduction > or = 50%) rates at study endpoint between treatment groups demonstrated that patients with melancholic depression and those with symptoms of psychomotor agitation yielded a significantly greater proportion of responders with sertraline compared to fluoxetine (P < 0.05). Response rates in sertraline- and fluoxetine-treated patients, respectively, were: overall study 59%, 51%; melancholia 59%, 44%; severe depression 59%, 41%; low anxiety 71%, 55%; high anxiety 47%, 48%; psychomotor retardation, 48%, 46%; and psychomotor agitation 62%, 39%. Multiple logistic regression adjusting for possible confounding factors, that included a treatment by anxiety interaction term, also led to similar findings. In particular, the analysis showed that significant differences existed in favour of sertraline in patients with low anxiety in the melancholia and severe depression subgroups (P < 0.05), indicating that these characteristics predicted a superior response to 6 weeks of treatment with sertraline relative to fluoxetine. Sertraline also demonstrated advantages over fluoxetine on parameters such as sleep and weight disturbance in severely depressed patients, and sleep disturbance, weight, cognitive disturbance and retardation in melancholic patients.     

Fluoxetine in the prevention of depressive recurrences: a double-blind study

Optimal outcomes from depression treatment are long-term recovery and, in the case of recurrent depression, prevention of new episodes. However, few data are available concerning the long-term efficacy of antidepressants in prophylactic treatment to prevent recurrences of depression. The efficacy and safety of fluoxetine 20 mg/day was evaluated in reducing the number of depressive episodes and in extending the time free of symptoms in patients with recurrent unipolar major depression. Patients with recurrent unipolar major depression according to DSM-III-R criteria and who responded to 32 weeks of open-label fluoxetine were randomly assigned to receive fluoxetine 20 mg/day (N = 70) or placebo (N = 70) for 48 weeks of double-blind maintenance treatment. Outcome measures were the percentage of recurrences and time to recurrence. Safety assessments included treatment-emergent adverse events, reasons for discontinuation, vital signs, and laboratory measures. Fluoxetine was associated with a statistically significantly smaller percentage of patients who had a recurrence compared with placebo (20% vs. 40%; chi2 analysis, p = 0.010). The symptom-free period was significantly longer for patients treated with fluoxetine versus placebo (295 vs. 192 days; Kaplan-Meier estimates, log-rank test, p = 0.002). Treatments were well tolerated during maintenance treatment. The only statistically significant difference in adverse events between treatment groups was anxiety, which was more frequent in the placebo group (fluoxetine, 12.9% vs. placebo, 30%; chi2 analysis, p = 0.013). Two placebo-treated patients and no fluoxetine-treated patients were withdrawn because of adverse events. In conclusion, fluoxetine at 20 mg/day was effective and well tolerated for the prophylactic treatment of recurrent unipolar major depression.     

Fluoxetine alone in the treatment of first episode anxious-depression: an open clinical trial

Many studies have reported the effectiveness of antidepressants in patients with so-called "anxious depression". This is the first report aimed at studying the beneficial therapeutic effects of fluoxetine alone on anxiety dimension in first episode drug naive patients suffering from DSM-IV major depression (MDD) and double depression (DD). Twenty-two outpatients (11 women and 11 men) were recruited in a University clinic for the treatment of a first episode pure MDD (n = 13) or DD (n = 9). All of the patients were drug naive, had Hamilton Rating Scale for Depression (HRSD) and Anxiety (HRSA) scores > or = 15, and were interviewed using the Structured Clinical Interview for DSM-IV-Patient edition. Fluoxetine alone (20 mg daily) was used in an attempt to treat depression with comorbid anxiety symptoms. A series of clinical- and self-rating scales (i.e., HRSD, HRSA, Beck Depression Inventory, and Stait Trait Anxiety Inventory) were used to measure the psychopathology at day 0, and every 10 days until day 50. In the whole group, there were statistically significant changes, starting from the baseline, in depression and anxiety symptoms after 10 days of treatment. Self evaluated anxiety, however, improved after 20 days. Furthermore, at day 50, the patients with comorbid DD experienced a major improvement (diminished anxiety symptoms) compared to pure MDD patients. This open study suggests that depression and anxiety symptoms in first-episode drug-naive patients with anxious depression diminished very quickly with fluoxetine.     

利培酮对焦虑抑郁共病的疗效比较

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86例焦虑抑郁共病患者随机分为研究组(利培酮 氟西汀)44例、对照组(氟西汀)42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周周末开始差异有显著性(P<0.05、P<0.01),两组疗效比较差异有显著性(P<0.05),各时期TESS评分比较差异无显著性(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。     

瑞波西汀片治疗抑郁症的多中心随机双盲临床研究

目的评价甲磺酸瑞波西汀(抗抑郁药)治疗抑郁症的有效性和安全性以及对伴焦虑症状抑郁症的疗效。方法采取多中心、随机、双盲双模拟、阳性药平行对照、剂量固定的研究方法,对212例抑郁症患者分别进行甲磺酸瑞波西汀(试验组105例)和盐酸氟西汀(对照组107例)治疗,观察疗程均为6周;以汉密尔顿抑郁量表(HAMD)作为主要疗效评价指标,以HAMA评分的变化评价治疗抑郁症伴焦虑症状的疗效;采用不良事件记录、实验室检查、生命体征等评价药物安全性。结果治疗6周末,2组HAMD总分减分值(15.91 vs 15.93)、HAMD总分减分率和治疗有效率差异均无统计学意义(P>0.05);2组HAMA总减分值差异无统计学意义(P>0.05)。2组药物不良反应发生率(20.56%vs 28.57%)差异无统计学意义(P>0.05)。结论甲磺酸瑞波西汀与盐酸氟西汀相似,是一种安全有效的新型抗抑郁药。     

氟西汀联合奋乃静治疗精神病性抑郁症

目的 :研究氟西汀联合奋乃静治疗精神病性抑郁症 (PD)的疗效及其安全性。方法 :氟西汀联合奋乃静组 (简称氟西汀组 ) 2 9例 ,予以氟西汀 2 0mg ,po ,qd ;阿米替林联合奋乃静组 (简称阿米替林组 ) 2 8例 ,予以阿米替林 75mg ,po ,bid。 2组均联合奋乃静 8mg ,po ,bid。 6wk为一个疗程。结果 :对抑郁症状的治疗 ,氟西汀组显效率为 76 % ,阿米替林组为 75 % ;对精神病性症状 ,2组显效率分别为 80 % ,82 %。 2组疗效经Ridit分析P >0 .0 5。而在HAMD“焦虑 /躯体化”因子分下降方面 ,氟西汀组更为显著。氟西汀组常见不良反应为口干(2 8% ) ,便秘 (2 1% ) ,视力模糊 (14 % ) ,恶心呕吐(10 % ) ,兴奋或激越 (10 % )等。结论 :氟西汀联合奋乃静治疗PD疗效肯定 ,不良反应较少 ,具有更高的依从性。     

氟西汀治疗脑卒中后抑郁20例

目的：探讨氟西汀治疗脑卒中后抑郁的疗效。方法：将４０例患者随机分为两组各２０例,对照组用常规治疗及心理治疗,氟西汀组在此基础上加用氟西汀２０ｍｇ／ｄ,ｐｏ。结果：氟西汀组ＨＡＭＤ分值明显下降,有效率９０．０％。结论：氯西汀对脑卒中后抑郁有良好疗效。