丁螺环酮与帕罗西汀联合治疗抑郁症的临床疗效分析

目的：探讨丁螺环酮与帕罗西汀联合方案治疗抑郁症患者的临床效果。方法：随机抽取2013年4月至2015年6月间我院接诊的患抑郁症的60例患者进行临床研究,通过随机分组法将所有患者随机分成对照组与研究组各30例。对照组单纯给予帕罗西丁口服治疗,研究组则在对照组的治疗基础上加用丁螺环酮联合进行治疗。观察和记录两组患者治疗前、治疗后的 HAMD 评分和 HAMD 评分变化情况。结果：经过为期6 w 的治疗后,研究组治疗的总有效率显著高于对照组（P ＜0．05）。结论：对抑郁症患者采用丁螺环酮与帕罗西汀联合进行治疗疗效显著,值得临床进一步推广应用。     

度洛西汀与帕罗西汀治疗广泛性焦虑对照研究

目的探讨度洛西汀与帕罗西汀治疗广泛性焦虑的临床疗效和安全性。方法将26例广泛性焦虑患者随机分为两组各13例,研究组口服度洛西汀胶囊治疗,对照组口服帕罗西汀治疗,观察6w。于治疗前及治疗2w、4w、6w末采用汉密顿焦虑量表和临床疗效总评量表的病情严重程度分量表评定临床疗效,副反应量表评定不良反应。结果两组治疗6w末总有效率均为100％。治疗1w末两组汉密顿焦虑量表总分均较治疗前有显著下降（P〈0．05或0．01）,但研究组较对照组下降更显著（P〈0．05）,随治疗时间的延续均呈持续性下降;两组治疗后临床疗效总评量表评分均较治疗前有显著下降（P〈0．01）;两组不良反应均较轻微。结论洛西汀治疗广泛性焦虑疗效显著,与帕罗西汀相当,但起效更快,安全性高,依从性好。     

利培酮合并帕罗西汀治疗强迫症疗效分析

目的：探讨利培酮合并帕罗西汀治疗强迫症的疗效。方法：40例强迫症患者随机分为利培酮合并帕罗西汀组和帕罗西汀组,治疗8周。采用强迫症量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评定疗效。结果：治疗结束时两组Y-BOCs、HAMA、HAMD的评分均显著降低,更以合用利培酮组明显。结论：利培酮合并帕罗西汀治疗强迫症可以增加疗效。     

帕罗西汀对慢性精神分裂症患者认知功能的影响

目的探讨帕罗西汀对恢复期慢性精神分裂症患者认知功能障碍的影响。方法将60例恢复期慢性精神分裂症患者随机分为两组各30例．两组在原抗精神病药物治疗的基础上研究组联合帕罗西汀治疗．对照组联合安慰剂治疗．疗程8w,采用简明精神病量表．韦氏成人智力量表．韦氏记忆量表．威斯康星卡片分类测验进行评定分析。结果治疗8w末,研究组认知功能改善显著优于对照组．两组治疗后各量表同期评分比较均有显著性差异（P〈0．05）。结论帕罗西汀可改善慢性精神分裂症患者的认知功能。     

帕罗西汀联合认知行为疗法治疗广泛性焦虑障碍对照研究

目的：探讨帕罗西汀联合认知行为疗法治疗广泛性焦虑障碍患者的疗效和安全性。方法将60例广泛性焦虑障碍患者按随机数字表法分为两组,每组30例,均晨口服帕罗西汀治疗,研究组联合认知行为治疗,观察8周。治疗前后采用汉密顿焦虑量表、汉密顿抑郁量表、症状自评量表评定疗效,副反应量表评定不良反应。结果两组汉密顿焦虑量表、汉密顿抑郁量表总分及症状自评量表躯体化、人际关系、抑郁、焦虑因子分均较治疗前显著下降（P＜0．01）,研究组评分显著低于对照组（ P＜0．05或0．01）;研究组总有效率为93．3％,对照组63．3％,研究组显著高于对照组（P＜0．01）。治疗后两组副反应量表评分及各项不良反应发生率比较差异均无显著性（P＞0．05）。结论帕罗西汀联合认知行为疗法治疗广泛性焦虑障碍患者具有协同增效作用,起效快,疗效显著,安全性高。     

电针与帕罗西汀治疗惊恐障碍的临床疗效

目的 比较电针疗法与帕罗西汀片治疗惊恐障碍的疗效和安全性。方法 将59例随机分为电针组(30例)和帕罗西汀组(29例),疗程为4周。在治疗前及治疗1、2、4、8周时采用焦虑自评量表(SAS)、汉密尔顿抑郁量表(HAMA)、疗效指数(CGI-EI)、Barthel指数(BI)量表评定疗效和不良反应。结果 电针组总有效率为86.66%,帕罗西汀组为82.76%,两组疗效差异无统计学意义;疗效指数及起效时间两组间有显著差异,电针组起效时间短、不良反应少。结论 两种方法治疗惊恐障碍疗效相当,但电针疗法起效时间短、疗效指数高、不良反应少。     

黛力新联合帕罗西汀治疗脑卒中后抑郁的临床观察

目的 观察黛力新联合帕罗西汀治疗脑卒中后抑郁患者的临床疗效. 方法 按照随机数字表法将我院收治的90例脑卒中后抑郁患者随机分为观察组和对照组. 两组患者均行脑卒中常规治疗,观察组在常规治疗基础上联合应用黛力新和帕罗西汀,对照组在常规治疗基础上单纯应用黛力新,28d为1个疗程. 观察对比两组患者的临床疗效、汉密顿抑郁量表( HAMD)评分、日常生活能力量表( ADL)评分、抑郁自评量表SDS、神经功能缺失评分NIHSS等情况. 结果疗程结束后,观察组总有效率达93. 3%,对照组总有效率为75. 6%,两组比较差异有统计学意义( P＜0. 05 );且观察组患者治疗后7d、28d的HAMD评分、ADL、SDS评分优于对照组,NIHSS优于对照组,两组比较差异有统计学意义(P＜0. 05).结论 联合应用黛力新和帕罗西汀治疗PSD,可有效改善患者抑郁,促进神经功能恢复,提高认知能力,比单纯应用黛力新的疗效更为显著,值得临床推广应用.     

新型抗抑郁药物的药物相互作用

新型抗抑郁药物的联合治疗及其与其他药物的联合应用可引起经细胞色素P450酶介导的多种药物的药动学改变,药物相互作用研究对临床合理用药具有重要意义。本文综述新型抗抑郁药物的药物相互作用,以期为临床用药提供参考。     

A prospective study comparing paroxetine alone versus paroxetine plus sildenafil in patients with premature ejaculation

PURPOSE: We compared the efficacy of paroxetine alone and combined with sildenafil in patients complaining of premature ejaculation. MATERIALS AND METHODS: Enrolled in this study were 80 consecutive potent men 19 to 47 years old (mean age 34) with premature ejaculation but without any obvious organic cause. Pretreatment evaluation included a history, self-administration of the International Index of Erectile Function (IIEF) questionnaire, physical examination and the Meares-Stamey test to exclude genital tract infection. The initial 40 patients received 10 mg. paroxetine daily for 21 days and then 20 mg. as needed, that is 3 to 4 hours before planned sexual activity, for 6 months (group 1). The other group of 40 men received 10 mg. paroxetine daily for 21 days and then 20 mg. as needed plus 50 mg. sildenafil as needed, that is 1 hour before planned sexual activity, for 6 months (group 2). Patients were followed 3 and 6 months after beginning therapy and were evaluated using several general assessment questions, IIEF and ejaculatory latency time. RESULTS: Mean ejaculatory latency time +/- SE in group 1 was 0.33 +/- 0.04, 3.7 +/- 0.10 (p <0.01) and 4.2 +/- 0.03 (p <0.01) minutes at baseline, 3 and 6-month followup, while in group 2 it was 0.35 +/- 0.03, 4.5 +/- 0.07 (p <0.01) and 5.3 +/- 0.02 (p <0.001) minutes, respectively. When improvement in ejaculatory latency time was compared in the 2 groups, group 2 results proved to be significantly greater (p <0.05). Baseline, and 3 and 6-month mean intercourse satisfaction domain values of the IIEF were 9, 11 and 11 (p = 0.09, not significant), and 9, 11 and 14 (p <0.05) in groups 1 and 2, respectively. Group 2 patients reported significantly greater intercourse satisfaction than those in group 1 (p <0.05). At baseline, 3 and 6 months there was a mean of 0.9 +/- 0.1, 1.7 +/- 0.3 (not significant) and 2.5 +/- 0.3 (p <0.01) coitus episodes weekly in group 1, and 1 +/- 0.2, 2.3 +/- 0.3 (p <0.01) and 3.2 +/- 0.1 (p <0.001) in group 2, respectively. Group 2 patients reported a significantly higher number of coitus episodes weekly (p <0.05). Side effects in the 40 group 1 cases included anejaculation in 1 (2.5%), gastrointestinal upset and/or nausea in 5 (12.5%), headache in 4 (10%) and decreased libido in 2 (5%). Side effects in the 40 group 2 cases included anejaculation in 1 (2.5%), headache in 8 (20%), gastrointestinal upset and/or nausea in 6 (15%) and flushing in 6 (15%). Group 2 patients reported significantly more headaches (p <0.01) and flushing episodes (p <0.001) than those in group 1. After 6 months of treatment 33 men (82.5%) in group 1 and 36 (90%) in group 2 were willing to continue therapy (not significant). CONCLUSIONS: Paroxetine combined with sildenafil appears to provide significantly better results in terms of ejaculatory latency time and intercourse satisfaction versus paroxetine alone in potent patients with premature ejaculation. However, combined treatment is associated with a mild increase in drug related side effects.     

Brysocarpus coccineus (Schum & Thonn) root reinstates sexual competence and testicular function in paroxetine‐induced sexual dysfunction in male Wistar rats

The effects of aqueous extract of Brysocarpus coccineus roots (AEBCR) were studied on sexual behaviour and testicular function of paroxetine‐induced sexual dysfunction (SD) in male rats. Ninety, sexually matured male rats (150.88 ± 5.53 g) were assigned into two groups: A and B. Fifteen SD animals from group B were each allotted to B1, B2, B3, B4 and B5 and received distilled water (DW), Powmax M (7.14 mg/kg body weight, b.w.) 50, 100 and 150 mg/kg b.w of AEBCR, respectively, for 7 days while the non‐SD animals (group A) received DW. Eleven secondary metabolites were present in AEBCR. The lowered (p < .05) ejaculation frequency, penile erection index and penile grooming, higher mount and intromission frequencies, prolonged (p < .05) latencies of mount, intromission, ejaculation, and post‐ejaculatory interval, reduced (p < .05) serum luteinising hormone, follicle stimulating hormone, testosterone, nitric oxide and testicular function indices, degenerated seminiferous tubules and low luminal spermatozoa contents by paroxetine were significantly (p < .05) attenuated and/or reinstated by AEBCR and Powmax M. The restoration of androgen‐dependent sexual and testicular functions in SD male rats by AEBCR validates its folkloric use as aphrodisiac. Clinical studies are desirable to ascertain the efficacy of AEBCR in SD.