艾司西酞普兰与舍曲林治疗门诊抑郁症的对照研究

目的 探讨艾司西酞普兰对门诊抑郁症病人的疗效和安全性。方法 68例符合CCMD-3抑郁发作的门诊病人随机分为艾司西酞普兰组和舍曲林组,艾司西酞普兰剂量10—20mg／d,舍曲林50～200mg／d,疗效采用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定,不良反应和安全性用TESS和实验室检查评定。观察时间为期6周。结果 艾司西酞普兰组有效率70．6％,治愈率47．1％,舍曲林组有效率61．8％,治愈率41．2％,两组比较差异无显著性。艾司西酞普兰主要不良反应为食欲下降（11．8％）、恶心（8．8％）、头晕（8．8％）、口干（5．9％）等,与舍曲林无差异。脱落率和失访率各为11．8％和14．7％,无显著差异。结论 艾司西酞普兰治疗门诊抑郁症病人安全有效,疗效和不良反应与舍曲林相似。     

艾司西酞普兰与舍曲林治疗抑郁症的对照研究

我们比较艾司西酞普兰与舍曲林对抑郁症患者的治疗效果和安全性,现报告如下。1对象和方法为2007年1月至2009年12月我院住院及门诊患者,均符合中国精神障碍分类与诊断标准第3版诊断标准的抑郁发作标准,     

艾司西酞普兰治疗老年抑郁症的疗效

目的：探讨艾司西酞普兰治疗老年期抑郁症的疗效与安全性。方法：61例老年期抑郁症患者随机分为艾司西酞普兰组31例和舍曲林组30例治疗6周,采用汉密尔顿抑郁量表（HAMD）,临床大体印象量表（CGI）,治疗中出现的症状量表（TESS）评定疗效及不良反应。结果：治疗6周,两组各量表评分均较治疗前有显著改善（P〈0.01）,艾司西酞普兰组治疗1周比舍曲林组改善显著（P〈0.05）,提示西酞普兰组起效快,有效率93.5%,舍曲林组为90%,两组疗效相当（P〉0.05）,两组不良反应轻微,无需特殊处理。结论：艾司西酞普兰治疗老年期抑郁症疗效显著,安全性高,起效快,耐受性好。     

艾司西酞普兰治疗抑郁症伴焦虑的疗效分析

目的评价国产艾司西酞普兰片治疗抑郁症伴焦虑的疗效及安全性。方法本研究为6周的多中心开放性研究,共入组符合CCMD-3诊断标准的抑郁症(同时HAMD≥17分、HAMA≥14分)患者173例,服用国产艾司西酞普兰片的剂量为10mg-20mg/d,分别在治疗前及第1、2、4、6周末以汉密尔顿抑郁量表17项(HAMD)、汉密尔顿焦虑量表(HAMA)和临床总体印象量表CGI(包括病情严重程度评分CGI-SI、疗效评分CGI-GI)评定疗效,以不良事件记录表、体格检查、实验室检查评估用药安全性。结果共169例患者完成研究,经6周治疗后显示,HAMD、HAMA、CGI-SI评分呈现一致的减分趋势,各时点HAMD-17、HAMA、CGI-SI的总分与治疗前比较,差异均有显著性(P<0.05),总体有效率为81.1%、痊愈率是63.9%。不良反应发生率为10.06%,一般可以耐受。结论国产艾司西酞普兰片治疗抗抑郁及焦虑作用确切,可用于治疗抑郁症伴焦虑障碍。     

艾司西酞普兰治疗伴焦虑症状的抑郁症疗效和安全性的研究进展

艾司西酞普兰是一种高选择性5-羟色胺(5-HT)再摄取抑制剂(SSRIs),其抗抑郁作用是通过抑制5-羟色胺转运因子提高5-羟色胺水平,从而激活中枢神经系统5-羟色胺能神经递质.适应症包括重度抑郁症及广泛性焦虑.临床中常常存在抑郁与焦虑共病的情况,而伴焦虑症状的抑郁症往往提示抑郁病情更严重.本文就艾司西酞普兰治疗伴焦虑症状的抑郁症疗效和安全性做一综述.     

艾司西酞普兰治疗老年抑郁症对照研究

目的:比较艾司西酞普兰与舍曲林治疗老年抑郁症的疗效和安全性. 方法:80例老年抑郁症患者随机分为艾司西酞普兰组和舍曲林组,每组40例,分别给予艾司西酞普兰和舍曲林治疗8周.采用蒙哥马利-阿斯伯格抑郁评价量表(MADRS),于治疗前及治疗1、2、4、6、8周评价疗效,并观察不良反应. 结果:治疗后两组MADRS评分均较治疗前明显下降;治疗各周的MADRS减分率以艾司西酞普兰组显著较高(P<0.05或P<0.01),起效更快,临床有效率和缓解率更高(P<0.05或P<0.01).两组不良反应均较少,艾司西酞普兰组不良反应发生率较舍曲林组更低(P<0.05). 结论:艾司西酞普兰和舍曲林治疗老年抑郁症疗效确切,服药依从性好.艾司西酞普兰起效快,不良反应少,适合老年抑郁症的一线用药.     

艾司西酞普兰与马普替林治疗抑郁症对照研究

本研究以艾司西酞普兰(商品名:来士普)与马普替林治疗抑郁症进行对照观察,报告如下。1对象和方法为我院住院及门诊患者。符合中国精神障碍分类与诊断标准第3版抑郁症诊断标准;年龄18~60岁;Hamilton抑郁量表(HAMD)前17项≥18分,抑郁自评量表(SDS)≥50分;无严重躯体疾病、癫、药物过敏及青光眼病史。共入组42例,按就诊顺序随机平分为两组。艾司西酞普兰组21例,男10例,女11例;平均年龄(42.3±10.1)岁;平均病程(6.4±5.9)年;HAMD总分(22.1±4.6)分,SDS总分(66.4±13.5)分。马普替林组21例,男9例,女12例;平均年龄(44.2±9.6)岁;平均病程(…     

艾司西酞普兰与帕罗西汀治疗伴焦虑症状的抑郁症随机对照研究

目的探讨艾司西酞普兰治疗伴焦虑症状抑郁症的疗效和安全性。方法采取随机对照研究方法,78例伴焦虑症状的抑郁症患者纳入研究,研究组服用艾司西酞普兰治疗,对照组服用帕罗西汀治疗,疗程6周。采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)进行疗效评定,采用副反应量表(TESS)对不良反应评估。结果研究组和对照组的有效率分别为52.5%和52.6%(P0.05),临床治愈率分别为87.5%和86.8%(P0.05);研究组恶心、心悸、头晕三项不良反应发生率(2.5%、2.5%、5%)均低于对照组(15.8%、18.4%、21.0%),差异有统计学意义(P0.05)。结论艾司西酞普兰治疗伴焦虑症状的抑郁症疗效与帕罗西汀相当,个别不良反应发生率低于帕罗西汀。     

艾司西酞普兰与西酞普兰治疗抑郁症对照研究

为探讨艾司西酞普兰对抑郁症的疗效和安全性,我们以西酞普兰为对照进行研究,报告如下。1对象和方法为2008年7月至2009年3月我院住院的抑郁症患者。     

艾司西酞普兰治疗抑郁症对照研究

目的：探讨艾司西酞普兰治疗抑郁症的疗效及安全性。方法：将63名抑郁症患者随机分为两组，分别给予艾司西酞普兰和马普替林治疗，疗程6周。采用汉密尔顿抑郁量表（HAMD）、临床疗效总评量表病情严重程度（CGI—SI）、治疗中出现的症状量表（TESS）评定疗效及不良反应。结果：艾司西酞普兰与马普替林治疗抑郁症疗效相当，但艾司西酞普兰起效更快，不良反应更少。结论：艾司西酞普兰治疗抑郁症安全有效。     

Escitalopram in the treatment of anxiety symptoms associated with depression

Most patients with depression have symptoms of anxiety associated with their illness. Our aim in this study was to investigate the efficacy of escitalopram, a proven antidepressant, on symptoms of anxiety in patients with major depressive disorder (MDD). Data from five placebo-controlled escitalopram studies in MDD were analyzed. Three of the studies also included a comparison with citalopram. In all studies, anxiety was assessed using the Inner Tension item (item 3) of the Montgomery-Asberg Depression Rating Scale (MADRS). In three studies, anxiety symptoms were also specifically assessed, either continuously over time or at baseline and end point, by using the Hamilton Rating Scale for Anxiety (HAM-A), the Anxious Mood item of the HAM-A (item 1), the Psychic Anxiety subscale of the HAM-A (items 1-6 and 14), the Anxiety Psychic item (item 10) of the Hamilton Rating Scale for Depression (HAM-D-24), and the Anxiety/Somatization subfactor (items 10-13, 15, and 17) of the HAM-D-24. Escitalopram was significantly superior to placebo in all comparisons. Citalopram was also consistently better than placebo in all comparisons, except in the HAM-D-24 Anxiety/Somatization subfactor. In some comparisons with placebo, escitalopram showed a significantly earlier onset of action or an earlier separation. Escitalopram was significantly more effective compared to placebo in treating both anxiety symptoms and the entire depression in the total depressive population, as well as in depressive patients with a high degree of anxiety.     

Escitalopram for the treatment of major depression and anxiety disorders

Escitalopram is the S-enantiomer of the selective serotonin reuptake inhibitor (SSRI) citalopram, which contains equal amounts of the S- and R-forms in a racemic mixture. Escitalopram is the most selective SSRI, with almost no significant affinity to other tested receptors. It has been demonstrated that it is escitalopram that carries the therapeutic potential of citalopram, and has statistically superior and clinically relevant properties compared with citalopram. Escitalopram is at least as effective in the treatment of depression and anxiety as other SSRIs, as well as venlafaxine, bupropion and duloxetine. Owing to multiple metabolic degrading pathways, the clinically relevant interactions of escitalopram with other drugs are minimal. Compared with other antidepressants, escitalopram is generally better tolerated, its onset of action is relatively fast, and its use may have cost-effectiveness and cost-utility advantages. Escitalopram is an effective first-line option in the management of patients with major depression, including severe forms, and various anxiety disorders.     

舍曲林联合小剂量奥氮平对抑郁焦虑共病患者的疗效

目的观察舍曲林联合小剂量奥氮平对抑郁焦虑共病的疗效、安全性及其对患者睡眠质量的影响,为抑郁焦虑共病的治疗提供参考。方法纳入2019年10月-2020年8月在甘肃省天水市第三人民医院和天水市复退军人精神病疗养院门诊就诊、符合《国际疾病分类(第10版)》(ICD-10)抑郁发作和广泛性焦虑障碍诊断标准的121例患者为研究对象,按照随机数字表法分为研究组(n=61)和对照组(n=60),研究组采用舍曲林联合小剂量奥氮平治疗,对照组采用舍曲林治疗,观察期8周。于治疗前和治疗后第1、2、4、6、8周采用汉密尔顿抑郁量表17项版(HAMD-17)和汉密尔顿焦虑量表(HAMA)评定病情严重程度,采用匹兹堡睡眠质量指数量表(PSQI)评定睡眠质量,采用副反应量表(TESS)评定药物不良反应。结果治疗后,两组HAMD-17、HAMA和PSQI评分均低于治疗前,差异均有统计学意义(P均0.05);治疗后各时点,研究组HAMD-17、HAMA和PSQI评分均低于对照组,差异均有统计学意义(P均0.05)。结论舍曲林联合小剂量奥氮平与单一舍曲林对抑郁焦虑共病的治疗均有效,但联合用药在改善焦虑和失眠症状方面的效果更好、安全性更高。     

Escitalopram in the treatment of generalized anxiety disorder

The selective serotonin reuptake inhibitor escitalopram is the active enantiomer of citalopram and has proven efficacy in the treatment of major depression, panic disorder and social phobia. Accumulating data indicate that it is also efficacious in the treatment of patients with generalized anxiety disorder. This drug profile summarizes the current evidence-base for the treatment of generalized anxiety disorder, describes the findings of a series of randomized placebo-controlled and comparator-controlled trials of escitalopram, examines the strengths and weaknesses of current treatment approaches and considers potential new therapies for the treatment of this common, chronic and impairing anxiety disorder. In summary, escitalopram is effective and well tolerated in both the short- and long-term treatment of generalized anxiety disorder, and has advantages over benzodiazepines and the selective serotonin reuptake inhibitor paroxetine.     

Effect of concurrent anxiety on response to sertraline and imipramine in patients with chronic depression

Anxiety commonly complicates the clinical presentation of depression and has been associated with poorer long-term outcome, but little information is available on the clinical correlates, and comparative effect on treatment response, of subsyndromic or secondary anxiety. Patients diagnosed with chronic major or double depression were randomized to 12 weeks of double-blind treatment with either sertraline or imipramine in a 2:1 ratio. A high anxiety subgroup was operationally defined by a HAM-D anxiety/somatization factor score > or = 7. The effect of study treatment was measured utilizing the HAM-D, CGI, HAM-D anxiety/somatization factor, as well as a quality of life measure (Q-LES-Q) and a measure of psychosocial functioning (the MOS-SF-36). Two hundred nine patients were treated with imipramine and 426 patients were treated with sertraline. Thirty-six percent of the total met criteria for the high anxiety subgroup. According to Kaplan-Meier probability estimates, patients with significant concurrent anxiety symptoms were more likely to respond by 12 weeks (66.4%) than those without significant anxiety symptoms (54.2%). There was no significant difference in response rates for sertraline vs. imipramine. Both drugs were effective at treating high baseline levels of anxiety, with 60% of sertraline patients and 58% of imipramine patients having 50% or greater reduction from baseline in HAM-D anxiety/somatization factor scores, and only 4.6% and 9.9%, respectively, reporting treatment-emergent worsening in anxiety at study endpoint. Despite the chronicity of depressive illness, acute treatment with both sertraline and imipramine significantly improved psychosocial and quality of life measures. High baseline levels of anxiety did not reduce overall antidepressant response but did somewhat delay the onset of response to sertraline or imipramine in patients with chronic depression.     

舍曲林治疗阿尔茨海默病伴发焦虑症状的临床研究

目的观察舍曲林对阿尔茨海默病伴发焦虑症状的临床疗效。方法将符合标准的60例患者随机分为治疗组和对照组,每组30例,两组均予多奈哌齐基础治疗,治疗组予舍曲林（25~50 mg/d）治疗,观察4周,采用汉密尔顿量表（HAMA）评定疗效,简易智力状态检查（MMSE）评定认知功能,副反应量表（TESS）评价安全性。结果两组基线HAMA评分无差异,第1周末治疗组HAMA评分低于对照组（治疗组为17.4±3.1,对照组为19.4±2.2,t=4.58,P〈0.01）,直至第4周末两组HAMA评分仍有差异（治疗组为11.1±2.6,对照组为16.3±3.7,t=8.03,P〈0.01）。治疗组有5例（16%）出现药物不良反应,对照组为4例（13%）,不良反应轻。结论舍曲林能有效治疗阿尔茨海默病伴发的焦虑症状。     

艾司西酞普兰与氟西汀治疗老年期抑郁症对照研究

目的观察艾司西酞普兰治疗老年期抑郁症的疗效和安全性。方法采用随机对照、开放标签设计,103例老年抑郁症患者随机分到艾司西酞普兰治疗组和氟西汀治疗组,治疗8周。汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评估患者疗效,意向治疗分析法（Intent to Treat Analysis,ITT）处理研究数据。对中途退出或失访的病例按照末次观察推进法（Last Observation Carried Forward,LOCF）处理缺失值。结果治疗8周脱落率艾司西酞普兰组低于氟西汀组,差异有统计学显著性（21％：41％,χ^2=4．82,P〈0．028）;完成8周疗效观察的病例,艾司西酞普兰组有效率为90．3％;氟西汀组有效率86．6％,两组差异无统计学差异（χ^2=1．282,P=0．673）;ITT分析显示两组8周时疗效显著性差异,艾司西酞普兰治疗组抑郁和焦虑症状评分改善的时间早于氟西汀组,且不良反应率低于氟西汀组。结论艾司西酞普兰治疗老年抑郁症患者疗效和耐受性均优于氟西汀。     

Suicidal thinking and behavior during treatment with sertraline in late-life depression.

OBJECTIVE: To determine effects of sertraline on suicidal thinking and behavior in patients with late-life major depression. METHODS: This was a secondary analysis of an eight-week, placebo-controlled, double-blind randomized trial of a multicenter trial at 66 clinical sites. Outpatients >/=60 years of age with major depression and a Hamilton Depression Rating (HAMD) score >/=18 were included. Intervention was sertraline 50-100 mg/day or placebo for eight weeks. Measurements were 17-item HAMD administered at baseline and two-week intervals. HAMD Item 3 used to assess suicidal ideation (SI) and behavior. Reports of serious adverse events (SAEs), adverse events (AEs) leading to discontinuation, and spontaneously reported adverse events reviewed. RESULTS: A total of 747 patients received at least one dose of medication, and 728 had at least one posttreatment assessment. Mean age (+/-SD) was 69.8 +/- 6.7 years (range: 59-97 years) and 56% were female. There were no completed suicides or suicide attempts during the double-blind trial. One SAE, hospitalization, was associated with SI in a patient on sertraline. No other AEs were associated with SI or behavior. HAMD Item 3 ratings progressively declined during the trial with significantly lower values for sertraline than placebo (Z = 2.41, p <0.02). In 248 patients with HAMD Item 3 of zero at baseline, the percentage of patients whose Item 3 ratings increased during treatment did not differ in the two groups (22.4% versus 25.8% for sertraline and placebo, respectively.) CONCLUSION: Sertraline was associated with significantly lower HAMD Item 3 scores than placebo during treatment. There was no evidence of greater emergent suicidal thinking or behavior with sertraline than placebo.     

文拉法辛与舍曲林治疗抑郁症对照研究

目的：比较文拉法辛与舍曲林治疗抑郁症的临床疗效和安全性。方法：将76例抑郁症患者随机分为文拉法辛组（38例）和舍曲林组（38例）,疗程6周。采用汉密尔顿抑郁量表17项（HAMD）评定疗效,治疗中出现的症状量表（TESS）评定不良反应和安全性。结果：文拉法辛组治疗1周起效;疗程结束时,两组疗效和HAMD评分差异无显著性,不良反应少而轻。结论：文拉法辛与舍曲林治疗抑郁症疗效相似,文拉法辛起效较快。