米氮平治疗广泛性焦虑症的疗效及安全性

目的:探讨米氮平治疗广泛性焦虑症的疗效和不良反应.方法:对60例广泛性焦虑症患者随机分为试验组及对照组,分别服用米氮平15～30mg·d-1和马普替林50～150mg·d-1,疗程均为6周.于治疗前及治疗后第1,2,4,6周末进行汉密尔顿焦虑量表(HAMD)及不良反应量表(TESS)评定疗效和不良反应.结果:试验组治疗广泛性焦虑症的显效率84.69%,有效率100%;对照组显效率66.67%,有效率88.89%,但两组比较经Ridit分析差异无显著性(P＞0.05).不良反应方面比较米氮平TESS评分显著低于马普替林(p＜0.05).结论:米氮平是治疗广泛性焦虑症的快速、安全、有效的药物.     

米氮平与丁螺环酮对照治疗广泛性焦虑疗效比较

目的:比较米氮平与丁螺环酮治疗广泛性焦虑的疗效和不良反应。方法:87例符合广泛性焦虑诊断标准的患者随机分成两组,试验组44例,口服米氮平15～45 mg·d~(-1);对照组43例,口服丁螺环酮15～40 mg·d~(-1),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)、Zung焦虑自评量表(SAS)和临床总体印象量表(CGI)评定临床疗效,不良反应量表(TESS)评价不良反应。结果:试验组和对照组显效率分别为75·0%和76．6%(P＞0．05),两组不良反应比较无显著性差异(P＞0．05)。结论:米氮平治疗广泛性焦虑安全有效。     

文拉法辛治疗抑郁症的临床对照研究

目的:评价文拉法辛治疗抑郁症的临床疗效和安全性.方法:将102例抑郁症患者随机分为试验组和对照组各51例,试验组用文拉法辛,起始剂量50mg·d-1,7～10d加至75～200mg·d-1;对照组用氟西汀,起始剂量为20mg·d-1,7～10d内加至40mg·d-1,两组疗程均为6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)和不良反应量表(TESS)评价疗效和不良反应.结果:试验组完成48例,有效率为83.3%,对照组完成49例,有效率为81.2%,两组有效率差异无显著性(P＞0.05),显效时间试验组为(6.7±3.3)d,对照组为(10.2±4.7)d,试验组显效较早(P＜0.05).TESS评分两组差异无显著性(P＞0.05).治疗第6周末两组HAMD和CGI-SI评分差异无显著性,治疗6周末开始两组评分差异无显著性(P＞0.05).结论:文拉法辛起效快,不良反应小,是一种安全有效的抗抑郁新药.     

帕罗西汀联合坦度螺酮治疗慢性阻塞性肺疾病合并焦虑与抑郁老年患者的临床研究

目的 探讨帕罗西汀联合坦度螺酮对慢性阻塞性肺疾病(慢阻肺)合并焦虑、抑郁老年患者的疗效及安全性.方法 将纳入的慢性阻塞性肺疾病合并焦虑、抑郁老年患者100例随机分为2组:对照组50例(用帕罗西汀20～40 mg·d-1治疗),试验组50例(用帕罗西汀20～40 mg·d-1联合坦度螺酮30 mg～60 mg·d-1治疗...     

右佐匹克隆治疗失眠症92例

目的 评价右佐匹克隆和佐匹克隆治疗失眠症的疗效和安全性.方法 将183例失眠症患者随机分成2组,治疗组92例,对照组91例.治疗组给予右佐匹克隆片3 mg·d-1,睡前服;对照组给予佐匹克隆胶囊7.5～15.0 mg·d-1,睡前服;两组疗程均为15 d,治疗前及治疗第8,15天后采用睡眠障碍量表(SDRS)、临床总体印象量表(CGI)和不良反应量表(TESS)评定临床疗效和不良反应.结果 两组治疗结束时SDRS评分较基线均有显著下降(P＜0.01),治疗组显效率83.7%,对照组显效率81.3%,两组疗效及不良反应比较差异无显著性(P＞0.05).结论 失眠症患者服用右佐匹克隆后睡眠状况明显改善,且不良反应少,患者易于接受.     

文拉法辛缓释剂与丁螺环酮治疗广泛性焦虑症对照观察

目的 了解文拉法辛缓释剂与丁螺环酮治疗广泛性焦虑障碍的疗效和安全性.方法 将符合入组标准的患者随机分为研究组和对照组,研究组口服文拉法辛缓释剂,对照组口服丁螺环酮,疗程4周.临床疗效判定依据汉密尔顿焦虑量表(HAMA)减分率,不良反应采用不良反应量表(TESS)评定.结果 研究组有效率为78.38％,对照组有效率为74.36％,两组有效率比较,差异无统计学意义(x2=0.17,P＞0.05).但在第2周时研究组抗焦虑效果优于对照组,两组不良反应比较,差异无统计学意义.结论 文拉法辛缓释剂与丁螺环酮治疗广泛性焦虑症均有较好的疗效,不良反应少,但文拉法辛缓释剂抗焦虑效果在治疗第2周时优于丁螺环酮.     

帕罗西汀与丁螺环酮治疗广泛性焦虑症的疗效比较

目的：比较帕罗西汀与丁螺环酮治疗广泛性焦虑的疗效和副反应。方法：符合CCMD-3广泛性焦虑症诊断标准的门诊和住院患40例，随机分为帕罗西汀组和丁螺环酮组，治疗6周，于治疗前及治疗后l，2，4，6周末用汉密尔顿焦虑量表、Zung焦虑自评量表(SAS)和不良反应症状量表(TESS)评定疗效和药物副反应。结果：帕罗西汀的疗效与丁螺环酮相当，均起效较慢，药物不良反应丁螺环酮组稍高于帕罗西汀组，但均反应轻微，不影响治疗。结论：帕罗西汀与丁螺环酮治疗广泛性焦虑症疗效确切，前副反应更少，服药方便，依从性好。     

帕罗西汀联合丁螺环酮增效治疗抑郁症对照研究

目的 探讨帕罗西汀联合丁螺环酮增效治疗抑郁症的疗效和安全性.方法 110例符合CCMD-3抑郁症诊断的患者分为2组,分别给予帕罗西汀联合丁螺环酮治疗(研究组)和单用帕罗西汀治疗(对照组),疗程均为6周.根据汉密尔顿抑郁量表(HAMD)减分率评定疗效,用副反应量表(TESS)评定用药的安全性,在治疗前和治疗后的1、2、4、6周末分别对2组进行评定.结果 研究组显效率为84.7%,对照组显效率为76.5%,研究组显效时间显著低于对照组,两组比较差异有显著性(P<0.001),两组不良反应均轻微,副反应量表评分两组比较差异无显著性(P>0.05).结论 帕罗西汀联合丁螺环酮治疗抑郁症疗效可增强,起效快,安全性好.     

盐酸安非他酮与盐酸氟西汀治疗抑郁症的临床研究

目的比较安非他酮与氟西汀对抑郁症的疗效和安全性。方法将125例抑郁症患者随机分为两组,研究组口服安非他酮治疗,对照组口服氟西汀治疗,均6周一个疗程。研究组63例,男30例,女33例;平均年龄(38.8±12.4)岁,平均病程(15.5±4.9)个月,予安非他酮300～450mg/d,po,tid。对照组62例,男28例,女34例;平均年龄(35.9±11.1)岁,平均病程(14.9±8.6)个月,予氟西汀20～40mg/d,po,qd。结果对抑郁症的治疗,安非他酮组显效率71%,氟西汀组为74%,两组间疗效比较无显著性差异(P>0.05);对伴随焦虑症状的治疗,安非他酮组显效率48%,氟西汀组显效率45%,两组比较无显著性差异(P>0.05)。两组不良反应发生率均较低,且程度较轻微。结论安非他酮与帕罗西汀治疗抑郁症总体疗效相当,能有效治疗抑郁及伴随焦虑症状,且安全性高。     

不同剂量度洛西汀治疗广泛性焦虑障碍的疗效与安全性

目的探讨不同剂量度洛西汀治疗广泛性焦虑障碍(GAD)的疗效与安全性。方法选择符合ICD-10诊断标准的GAD住院或门诊患者,随机分为度洛西汀60 mg·d-1(A组)、90 mg·d-1(B组)、120 mg·d-1(C组)和帕罗西汀组(D组),每组各40例。度洛西汀组开始均口服度洛西汀30 mg·d-1,并逐渐增加到目标剂量,D组口服帕罗西汀10 mg·d-1,渐增加到个体所需量,失眠患者睡前服唑吡坦。治疗后第1、2、4、8周末,评定汉密尔顿焦虑量表(HAMA)。入组时及第8周末查心电图,血、尿常规,肝、肾功能。结果 A、B、C、D四组患者实际完成研究分别为35、33、34、35例,D组帕罗西汀平均剂量为(32.2±8.4)mg·d-1。治疗后第2周末B、C组HAMA得分开始低于A、D组,并一直持续到第8周末(P<0.05或P<0.01)。度洛西汀90、120 mg·d-1对GAD症状的改善优于度洛西汀60 mg·d-1和帕罗西汀(P<0.05)。四组的治愈率分别为47%、55%、59%、46%,有效率分别为75%、85%、85%、74%,组间比较均无显著差异(P>0.05)。四组不良反应出现率无显著意义(P>0.05)。结论度洛西汀治疗GAD疗效确切且安全,90~120 mg·d-1对GAD症状的改善优于度洛西汀60 mg·d-1与帕罗西汀。     

Comparison of buspirone and diazepam in generalized anxiety disorder

A total of 66 outpatients meeting Diagnostic and Statistical Manual (DSM-III) criteria for generalized anxiety disorder began treatment in a randomized double-blind study that compared the efficacy and safety of buspirone and diazepam. Thirty-nine outpatients completed the 4-week trial. Both drugs were administered in a 1:1 dosage ratio; the daily prescribed dose did not exceed 40 mg. The mean daily dose of buspirone prescribed throughout the study was significantly higher than that of diazepam. Diazepam had a significantly earlier onset of efficacy than buspirone, although both drugs were equivalent after 4 weeks of treatment. Adverse reactions were more frequent in the diazepam group. Total scores from the Hamilton anxiety scale and physician's global ratings show that diazepam was significantly superior to buspirone during the initial 2 weeks of treatment. These findings are further corroborated by the results of patients' self-rated scales.     

Efficacy of Venlafaxine ER in patients with social anxiety disorder: a double-blind, placebo-controlled, parallel-group comparison with paroxetine

This study evaluated the anxiolytic efficacy, safety and tolerability of a flexible dose of venlafaxine extended release (ER) compared with placebo and paroxetine in the short-term treatment of generalized social anxiety disorder (SAD). Adult outpatients with generalized SAD (n = 434) were randomized to receive capsules of venlafaxine ER 75 mg to 225 mg/day, paroxetine 20 mg to 50 mg/day, or placebo for 12 weeks. The primary efficacy variable was the Liebowitz social anxiety scale total score. Secondary efficacy variables included the patient-rated social phobia inventory and the proportion of responders in each group (a responder was defined as having a clinical global impression-improvement score of 1 or 2). Treatment with venlafaxine ER was associated with significantly greater improvement than treatment with placebo for all primary and secondary efficacy variables (p < 0.05). No significant differences in primary or secondary efficacy variables were observed between the venlafaxine ER and paroxetine groups. The week 12 response rates were 69%, 66% and 36% for the venlafaxine ER, paroxetine and placebo groups, respectively. Both active treatments were generally well tolerated and were associated with a similar incidence of adverse events. This study shows that venlafaxine ER is an effective, safe and well-tolerated drug treatment for SAD.     

几种抗焦虑药的临床应用及不良反应的比较研究

目的比较目前临床上应用的几种治疗广泛性焦虑症药物的疗效及安全性。方法将150例广泛性焦虑症病人分成5组：曲唑酮组;丁螺环酮组;坦度螺酮组;文拉法辛组;帕罗西汀组。结果组间比较用SNK-q检验,P〉0.05,5组疗效无显著性差异。药物不良反应发生率相似。结论 5种抗焦虑药治疗广泛性焦虑症疗效及安全性相似。     

Paroxetine: new indication. In generalised anxiety: uncertain efficacy

(1) Generalised anxiety is defined as overwhelming anxiety lasting at least 6 months. (2) Psychological treatment should be tried first. When the patient fails to cope the first-line drug is a benzodiazepine such as diazepam, prescribed for a short period. (3) In France, generalised anxiety has now been added to the licensed indications of paroxetine, a "selective" serotonin reuptake inhibitor antidepressant. Two placebo-controlled trials lasting 8 weeks showed a moderate improvement on the Hamilton anxiety score. Another trial showed no significant difference between the paroxetine and placebo groups. The clinical relevance of this improvement is unclear, however, and the trials suffered from methodological biases. Paroxetine has not been reliably compared with benzodiazepines, psychotherapy or buspirone in patients with generalised anxiety. (4) One trial showed 11% relapse in the paroxetine group and 40% in the placebo group during the 6 months following paroxetine withdrawal, among patients who had initially responded; once again, however, methodological flaws undermine these data. (5) The adverse effect profile of paroxetine in generalised anxiety is similar to its profile in other patients: in particular potentially serious drug interactions and withdrawal symptoms when treatment is stopped abruptly. (6) In practice, the standard drug therapy for generalised anxiety is a benzodiazepine such as diazepam. Paroxetine, whose clinical efficacy remains to be established in this setting, offers no tangible therapeutic advance.     

丁螺环酮与帕罗西汀联合治疗焦虑症患者的临床效果探讨

目的探讨焦虑症患者应用丁螺环酮联合帕罗西汀治疗的临床效果。方法 80例焦虑症患者,采用抽签法分为对照组和观察组,每组40例。对照组患者采用帕罗西汀治疗,观察组患者采用丁螺环酮联合帕罗西汀治疗。比较两组患者的治疗效果、治疗前后焦虑自评量表(SAS)评分以及治疗期间不良反应发生情况。结果观察组患者的治疗总有效率为95.00%,显著高于对照组的75.00%,差异具有统计学意义(P<0.05)。治疗前,两组患者SAS评分比较差异无统计学意义(P>0.05);治疗后,两组患者的SAS评分均显著低于本组治疗前,且观察组低于对照组,差异均具有统计学意义(P<0.05)。观察组患者治疗期间不良反应发生率为5.00%,显著低于对照组的20.00%,差异无统计学意义(P<0.05)。结论焦虑症患者采取丁螺环酮联合帕罗西汀治疗,能够提高治疗效果,改善焦虑状态,同时减少用药不良反应。     

帕罗西汀联合阿普唑仑治疗广泛性焦虑症的疗效观察

目的探讨帕罗西汀联合阿普唑仑治疗广泛性焦虑症患者的疗效,关注其对焦虑和抑郁评分的影响,以期为临床工作提供帮助。方法收集本院诊治的广泛性焦虑症的患者80例,随机分为观察组（40例）与对照组（40例）,对照组单纯应用帕罗西汀治疗,观察组应用帕罗西汀联合阿普唑仑治疗,观察治疗对患者焦虑和抑郁评分的影响。结果观察组在治疗2、4、8周后对焦虑和抑郁的改善情况明显优于对照组,两组差异有统计学意义（P〈0.05）。结论帕罗西汀联合阿普唑仑治疗广泛性焦虑症患者的疗效明显,对焦虑和抑郁改善的效果理想,临床中可以积极应用。     

广泛性焦虑症患者住院药物治疗的探讨

目的:探讨帕罗西汀联合氯硝西泮静脉用药治疗广泛性焦虑症临床效果及起效特点。方法:将70例广泛性焦虑障碍患者随机分为两组。研究组36例用帕罗西汀的同时,给予氯硝西泮静脉用药治疗;对照组34例只给予帕罗西汀治疗。两组于治疗前和治疗后第一天、2周、3周、4周末采用汉密尔顿焦虑量表和不良反应量表评定临床疗效与不良反应,并进行比较。结果:帕罗西汀对广泛性焦虑障碍有明显疗效,帕罗西汀联合氯硝西泮静脉用药效果显著,显效更快。在治疗1天及1周末,两组HAMA总分有极显著性差异,两组TESS分有显著性差异。结论:广泛性焦虑症患者住院治疗,用帕罗西汀联合氯硝西泮静脉用药见效快,效果显著。     

A comparison of buspirone, diazepam, and placebo in patients with chronic anxiety states

Buspirone is an antianxiety compound that has been extensively evaluated in clinical trials: it has proved superior to placebo and comparable to diazepam in the treatment of patients with generalized anxiety disorder. In this study, 33 outpatients with generalized anxiety disorder were entered into a crossover study of 3 weeks each of placebo, buspirone 10 to 30 mg daily, and diazepam 10 to 30 mg daily. Psychiatrist and patient ratings were made, together with psychological tests and EEG and skin conductance measures before and after each treatment. Of the nine dropouts, six were on buspirone at the time of dropout. For the remaining 24 patients, the mean daily doses attained of buspirone and diazepam were both 20 mg. On most clinical ratings diazepam was superior to buspirone and placebo, which did not differ. Diazepam produced minor psychomotor changes and the expected major effects on the EEG. Buspirone was without effect. Side effects on buspirone were mainly nausea and giddiness and on diazepam, drowsiness. The lack of efficacy of buspirone is discussed in terms of the previous benzodiazepine exposure--23/24 patients had had previous exposure and only 10 were able to tolerate a pretrial placebo washout period. The implications are considerable for the introduction of any new antianxiety agent not cross-tolerant with the benzodiazepines into a chronically anxious group of patients with previous long-term benzodiazepine therapy.     

A double blind comparison of venlafaxine and paroxetine in obsessive-compulsive disorder

SUMMARY: While the usefulness of clomipramine and selective serotonin reuptake inhibitors (SSRIs) in obsessive-compulsive disorder (OCD) has been established, the efficacy of serotonin-norepinephrine reuptake inhibitors remains to be determined. This report describes the first randomized double-blind comparison study of an SNRI in patients with obsessive-compulsive disorder. The current study compares the efficacy and tolerability of venlafaxine with paroxetine. One hundred and fifty patients with primary OCD according to DSM-IV criteria were randomly assigned in a 12-week double-blind trial to receive dosages titrated upward to 300 mg/d of venlafaxine (n = 75) or 60 mg/d of paroxetine (n = 75). Primary efficacy was assessed by the change from baseline on the Yale-Brown obsessive-compulsive scale (Y-BOCS). Other assessments throughout the trial included the Hamilton depression rating scale, and the Hamilton anxiety rating scale. An intent-to-treat, last-observation-carried-forward analysis demonstrated a mean decrease on the Y-BOCS of 7.2 +/- 7.5 in the venlafaxine group and of 7.8 +/- 5.4 in the paroxetine group. In both treatment groups, a responder rate (decrease > 35% on the Y-BOCS) of approximately 40% was found. There were no significant differences between venlafaxine and paroxetine with regard to response or responder rates. The incidence of adverse events for venlafaxine and paroxetine was comparable. The most common side effects for venlafaxine were somnolence, insomnia, a dry mouth, and sweating; and for paroxetine somnolence, sweating, nausea, and headache. These results show that venlafaxine was equally effective to paroxetine in treating patients with OCD. Venlafaxine may be a useful therapy for obsessive-compulsive patients, but is not superior to SSRIs.     

A comparative study of the efficacy of long-term treatment with escitalopram and paroxetine in severely depressed patients

OBJECTIVE: This randomised, double-blind, fixed-dose study evaluated the efficacy of escitalopram and paroxetine in the long-term treatment of severely depressed patients with major depressive disorder (MDD). RESEARCH DESIGN AND METHODS: Patients with a primary diagnosis of MDD and baseline Montgomery-Asberg Depression Rating Scale (MADRS) >or= 30 were randomised to 24 weeks of double-blind treatment with fixed doses of either escitalopram (20 mg) (n = 232) or paroxetine (40 mg) (n = 227). The primary analysis of efficacy was an analysis of covariance (ANCOVA) of change from baseline to endpoint (Week 24) in MADRS total score (last observation carried forward, LOCF). MAIN OUTCOME MEASURES; RESULTS: At endpoint (24 weeks), the mean change from baseline in MADRS total score was -25.2 for patients treated with escitalopram (n = 228) and -23.1 for patients with paroxetine (n = 223), resulting in a difference of 2.1 points (p < 0.05). The difference in the change in the MADRS total score (LOCF) was significantly in favour of escitalopram from Week 8 onwards. The proportion of remitters (MADRS or= 35), there was a difference of 3.4 points at endpoint in the MADRS total score in favour of escitalopram (p < 0.05). The overall withdrawal rate for patients treated with escitalopram (19%) was significantly lower than with paroxetine (32%) (p < 0.01). The withdrawal rate due to adverse events was significantly lower for escitalopram (8%) compared to paroxetine (16%) (p < 0.05). There were no significant differences in the incidence of individual adverse events during treatment. CONCLUSION: Escitalopram is significantly more effective than paroxetine in the long-term treatment of severely depressed patients.