帕罗西汀与多塞平治疗抑郁症的对照研究

目的研究帕罗西汀与多塞平治疗抑郁症的疗效及安全性。方法将60例抑郁症患者随机分为两组,分别用帕罗西汀和多塞平治疗。采用HAMD、HAMA、CGI量表评定疗效,采用TESS量表、实验室检查评价安全性。结果帕罗西汀组与多塞平组治疗前、后HAMD、HAMA、CGI SI评分及减分比较无显效性差异(P>0.05),但帕罗西汀副作用发生率低而轻微。结论帕罗西汀是一种安全有效的抗抑郁药。     

托特罗定联合多虑平治疗女性膀胱过度活动症

目的：观察托特罗定联合多虑平治疗女性膀胱过度活动症的临床疗效,探讨女性膀胱过度活动症的治疗方法。方法：将106例女性膀胱过度活动症患者随机分为两组,治疗组60例给予托特罗定2 mg,同时服用盐酸多塞平（多虑平）25 mg,每晚1次口服;对照组46例仅服用相同剂量的托特罗定,疗程均为4周。结果：治疗后治疗组以平均24 h排尿次数、平均24 h尿失禁次数、初始尿意容量、FDV、MCBC、Qmax均较对照组改善显著（P〈0.05）。结论：初步观察,托特罗定加盐酸多塞平（多虑平）治疗女性膀胱过度活动症,耐受性好、安全有效的药物,较单独使用疗效更佳。     

文拉法新缓释片治疗广泛性焦虑症临床观察

目的评价文拉法新缓释片治疗广泛性焦虑症的疗效与安全性。方法将60例广泛性焦虑症患者随机分为文拉法新缓释片组30例,多塞平组30例,疗程8周。以汉密尔顿焦虑量表(HAMA)和不良反应量表评定疗效和不良反应。结果两组治疗后与治疗前的HAMA评分比较,差异均有统计学意义(P<0.05)。两组疗效及HAMA评分比较差异无统计学意义(P>0.05),文拉法新组不良反应明显少于多塞平组。结论文拉法新缓释片治疗广泛性焦虑疗效确切,安全性好。     

小剂量多塞平联合莫沙必利治疗功能性消化不良的临床观察

目的探讨莫沙必利联合抗抑郁药多塞平治疗功能性消化不良的疗效及安全性。方法将127例功能性消化不良患者随机分为试验组（64例）和对照组（63例）。试验组给予莫沙必利5mg每日3次,饭前30min口服,多塞平12.5mg睡前口服;对照组单用莫沙必利,疗程均为8周。分别于治疗前及治疗第1、2、4、8周末进行疗效评价。结果试验组治疗1、8周末总有效率分别为39.06%和82.81%。对照组治疗1、8周末总有效率分别为19.04%和36.50%,2组比较有显著性差异。结论莫沙必利联合多塞平治疗功能性消化不良具有良好的临床疗效。     

文拉法辛联合小剂量多塞平治疗躯体形式障碍的疗效观察

目的探讨文拉法辛联合小剂量多塞平治疗躯体形式障碍的疗效及安全性。方法将64例躯体形式障碍患者随机分为研究组(文拉法辛联合多塞平组)与对照组(文拉法辛组)各32例,分别予文拉法辛联合小剂量多塞平与文拉法辛治疗,疗程均为8周。临床疗效评定分别采用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、临床疗效总评量表-病情严重度(CGI-SI)及治疗时出现的症状量表(TESS)于治疗前后进行评定。结果研究组在治疗第2,4,6,8周末HAMA总分显著低于对照组,差异有统计学意义(P<0.05)。研究组在治疗第2周末精神性焦虑分低于对照组,差异有统计学意义(P<0.05)。研究组在治疗第2,4周末HAMA减分率均高于对照组,差异有统计学意义(P<0.05)。研究组在治疗第2,8周末HAMD总分显著低于对照组,差异有统计学意义(P<0.05或P<0.01)。研究组在治疗第2,8周末HAMD减分率均高于对照组,差异均有统计学意义(P均<0.01)。研究组总有效率为93.75%与对照组总有效率为87.50%比较,差异无统计学意义(P>0.05),研究组的显效率为75.00%与对照组的50.00%比较,差异有统计学意义(P<0.05)。两组的不良反应均少,在治疗第8周末两组的TESS评分比较差异无统计学意义(P>0.05)。结论文拉法辛联合小剂量多塞平治疗躯体形式障碍疗效优于单用文拉法辛,且无明显不良反应。     

Doxepin: Effects on transport of biogenic amines in man

A new tricyclic antidepressant, doxepin, was evaluated for its ability to block the amine uptake mechanism of the peripheral adrenergic neuron and blood platelet in man. At low doses, there was no evidence of inhibition of the amine pump. However, at moderate doses (200–300 mg/day), necessary for effective antidepressant activity, doxepin was found to inhibit the pressor responses to tyramine and to reduce platelet 5-HT. These studies indicate that doxepin is a less potent inhibitor of the amine pump in the peripheral adrenergic neuron and blood platelet than is DMI or protriptyline. Doxepin, at the antidepressant dose level does alter biogenic amine uptake, an effect consistent with the biogenic amine hypothesis of depression. However, at 300 mg/day, a dose which blocks the pressor response to tyramine, antagonism of the antihypertensive effects of guanethidine and related drugs was demonstrated.This investigation was supported in part by Public Health Service Grant Numbers: MH 11468; 2 T01 HE 05545; 1 P11 GM 15431; 5 R01 HE 10842; 5 M01 RR 00095-10; RR 95.Dr. Oates is a Burroughs-Wellcome Scholar in Clinical Pharmacology.     

通便解郁汤配合多塞平治疗肛周不适为主诉的抑郁性神经症临床效果观察

目的观察口服自拟通便解郁汤配合多塞平治疗以肛周不适为主诉的抑郁性神经症的临床效果。方法对60例以肛周不适为主诉的抑郁性神经症患者随机分为治疗组(32例)和对照组(28例),治疗组口服自拟通便解郁汤(1剂/d)并配合多塞平25 mg,每晚1次。对照组单纯口服多塞平(每晚睡前服,50 mg)。两组均治疗1个疗程(3个月),对比观察两组疗效。结果治疗组痊愈20例(62.5%),显效12例(37.5%);对照组痊愈6例(21.43%),显效6例(21.43%),有效16例(57.14%)。两组愈显率比较,差异有统计学意义(Z_C=4.5279,P0.05)。结论通便解郁汤配合多塞平治疗以肛周不适为主诉的抑郁性神经症有良好的临床疗效。     

联合使用多虑平治疗慢性胃炎的临床疗效观察

目的　观察抗抑郁剂在慢性胃炎治疗中的作用。方法　在常规治疗的基础上联合使用多虑平治疗慢性胃炎 85例 ,并以行常规治疗的 82例做对照。结果　观察组 85例中 81例痊愈 (95 .3% ) ,4例好转 (4 .7% ) ;对照组 12例痊愈 (14 .6 % ) ,30例好转 (36 .6 % ) ,4 0例无效 (4 8.8% )。两组疗效有显著性差异 (P <0 .0 1)。结论　在常规治疗的基础上联合使用多虑平治疗慢性胃炎可明显提高疗效。     

Doxepin and its metabolites in plasma and cerebrospinal fluid in depressed patients

Little information exists on the concentrations of antidepressants and their metabolites in CSF. We measured plasma and CSF levels of trans-doxepin (trans-DOX) and DOX metabolites in 12 depressed patients treated with DOX (250 mg/day) for 6 days. Spinal taps and blood samples were taken on day 7, 10 h after drug administration. Trans-DOX, cis-desmethyldoxepin (cis-DM-DOX), trans-desmethyldoxepin (trans-DM-DOX) and di-desmethyldoxepin (DDM-DOX) were analyzed in CSF and plasma samples by HPLC with column-switching. Although DOX was given as a mixture of 85% trans-DOX and 15% of the pharmacologically more active cis-DOX, we found similar amounts of cis-DM-DOX and trans-DM-DOX in plasma (59.8 ± 45.1 versus 72.0 ± 60.0 ng/ml; NS), suggesting that isomerization of DOX had taken place. Trans-DOX and DOX metabolites could be detected in CSF of most patients. Relatively low CSF concentrations of the active metabolite cis-DM-DOX were measured. Clinical efficacy, as assessed by HAMD scores, was not significantly related to plasma or CSF concentrations of trans-DOX or its metabolites. Trans-DOX and DOX metabolites were distributed differently between plasma and CSF. It is concluded that isomerization of DOX is not only relevant for neuronal uptake inhibition, but also for the transport of the metabolites. Received: 13 May 1996/Final version: 16 December 1996     

HPLC法同时测定人血浆中6种抗抑郁药的浓度

目的:建立一种快速、灵敏的同时测定人血浆中6种抗抑郁药浓度的高效液相色谱法。方法:以异丙嗪为内标,样品碱化后液-液萃取,用Phenomenex-C18反相色谱柱进行分离,以乙腈-0.05mol.L-1磷酸二氢钠溶液(用磷酸调节pH=2.5)为流动相,采用梯度洗脱;流速为1.2mL.min-1,柱温为40℃;荧光检测文拉法辛,激发波长为276nm,发射波长为598nm;紫外检测多塞平、帕罗西汀、舍曲林、氟西汀和阿米替林,检测波长为200nm。结果:文拉法辛、多塞平、帕罗西汀、舍曲林、氟西汀、阿米替林血药浓度分别在5～1000、4～200、20～800、20～800、40～1000、10～400μg.L-1范围内线性关系良好,r均≥0.990;日内、日间RSD均<15%,提取回收率均>60%,方法回收率均>90%。结论:本方法简便、快速、经济、准确、灵敏,可用于血药浓度的临床监测、中毒药物分析及药动学研究。