帕罗西汀与阿米替林治疗躯体形式障碍对照研究

目的探讨帕罗西汀治疗躯体形式障碍的临床疗效及安全性。方法将42例躯体形式障碍患者随机分为两组各21例,研究组应用帕罗西汀治疗,对照组应用阿米替林治疗,观察8w。于治疗前及治疗第2w、4w、6w、8w末采用症状自评量表评定疗效,副反应量表评定不良反应。结果治疗8w末两组症状自评量表各因子分均较治疗前有极显著下降(P<0.01);治疗2w、4w末对照组焦虑、抑郁因子分较研究组下降显著(P<0.05);4w、6w末研究组躯体化因子较对照组下降显著(P<0.05);8w末两组间各因子分均无显著性差异(P>0.05),两组总体疗效相当;治疗2w、4w、6w、8w末研究组副反应量表总分均显著低于对照组(P<0.01)。结论帕罗西汀治疗躯体形式障碍安全有效,不良反应轻微,患者依从性好。     

星状神经节阻滞与阿米替林治疗早泄对照研究

目的比较星状神经节阻滞与阿米替林治疗早泄的疗效及安全性。方法将60例早泄患者随机分为两组各30例,研究组用星状神经节阻滞治疗,隔日1次,7次为1疗程。对照组性交前1h口服阿米替林治疗12.5mg·d-1,15d为1疗程。比较两组疗效及安全性。结果两组治疗后早泄较治疗前均有极显著性改善(P<0.01),但研究组比对照组改善更显著,两组差异有极显著性(P<0.01)。结论星状神经节阻滞治疗早泄治愈率高,起效时间快,不良反应轻,复发率低。     

Interstitial cystitis: bladder pain and beyond

Background: Interstitial cystitis is characterized by over 6 months of chronic pain, pressure and discomfort felt in the lower pelvis or bladder. It is often relieved with voiding, along with daytime frequency and nocturia in the absence of a urinary tract infection. Interstitial cystitis occurs primarily in females including adolescents and its diagnosis is still one of exclusion. It is now recognized as a serious medical condition associated with significant disability. Objective: The aim of this paper was to review the pathogenesis and treatment of interstitial cystitis with emphasis on new pathogenetic trends and therapeutic modalities. Methods: About 713 mostly original papers were reviewed in Medline from 1990 to August. 2008. All authors independently reviewed the literature. Large, double-blind, placebo-controlled, clinical trials were few and the medical histories of the patients used varied considerably making conclusions difficult. Promising pilot trials turned out mostly negative on follow-up. Results: Increasing evidence of co-morbid diseases, neurogenic inflammation and the effect of stress are promising as new targets for pathophysiology. No new effective treatments have emerged. Oral pentosanpolysulfate, amitriptyline, hydroxyzine and quercetin, as well as intravesical heparin/bicarbonate/lidocaine solutions, are still used with variable success. Some pilot open-label trials presented encouraging findings. Conclusion: Interstitial cystitis contributes substantially to chronic pelvic pain and to poor quality of life. Oral or intravesical administration of solutions containing sodium hyaluronate, chondroitin sulfate and quercetin to both reduce bladder inflammation and ‘replenish’ the glycosaminoglycan layer should be tried. There is a clear need for therapeutic modalities. New potential translational research areas are suggested.     

Daledalin Tosylate: A Controlled Trial in Depressive Illness

Summary

Pharmacological studies of a novel chemical - daledalin tosylate (UK 3557), an indoline compound - suggested the possibility of antidepressant activity with fewer autonomic side-effects in man. A double-blind comparison of daledalin tosylate and amitriptyline hydrochloride as a standard reference antidepressant was carried out in 28 patients with depressive illnesses. Sixteen patients received daledalin tosylate and 12 amitriptyline hydrochloride. The concept of ‘depressive illness’ and the criteria for inclusion in the study are discussed at length.

No statistically significant differences between the two drugs could be found in the Hamilton Rating Scale for Depression, the Wakefield Self-Assessment Depression Scale, global assessment of severity of illness or change in condition, side-effects check list, or the trend analysis of the laboratory results by linear regression.

It was concluded that daledalin tosylate had antidepressant effects comparable with amitriptyline but no clinical advantages over the latter.     

Epinephrine potentiates the analgesic and antidepressant effects of amitriptyline as a result of stimulation of the gastric mucosal afferents

Intramuscular amitriptyline in the minimum effective dose causes maximum analgesic and antidepressant effect and significant sedation in rats. Combined injection of amitriptyline with epinephrine in the threshold doses (ineffective if used alone), 1/10 and 1/30 minimum effective doses, respectively, leads to the development of the maximum analgesic and antidepressant effect, but causes no sedative side effect. This potentiation is mediated by stimulation of afferents in the gastric mucosa with epinephrine. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 144, No. 11, pp. 535–537, November, 2007     

国产米氮平与阿米替林治疗抑郁障碍对照研究

目的 探讨国产米氮平与阿米替林治疗抑郁障碍的临床疗效和安全性.方法 将64例抑郁障碍患者随机分为两组,每组32例,研究组口服国产米氮平治疗,对照组口服阿米替林治疗,观察6周.于治疗前及治疗1周、2周、4周、6周末采用汉密顿抑郁量表评定临床疗效,副反应量表评定不良反应.依据汉密顿抑郁量表评分统计两组治疗前后抑郁症状检出率,同时评估两组患者服药依从性.结果 治疗后两组汉密顿抑郁量表评分均较治疗前呈持续性显著下降(P＜0.01),减分率呈持续性升高.研究组治疗1周末、2周末汉密顿抑郁量表评分较对照组下降更显著,减分率较对照组升高更显著(P＜0.05).治疗6周末除对照组自责、自杀念头症状检出率与治疗前差异无显著性外(P＞0.05),两组各种抑郁症状检出率均显著低于治疗前(P＜0.01);研究组兴趣丧失、自责、自杀念头症状检出率均显著低于对照组(P＜0.01),其他症状检出率差异均无显著性(P＞0.05).研究组不良反应发生率为21.9%,对照组为46.9%,研究组显著低于对照组(χ2=4.43,P＜0.05);服药依从性显著高于对照组(P＜0.01).结论 国产米氮平治疗抑郁障碍疗效显著,与阿米替林相当,但起效更快,安全性更高,依从性更好,优于阿米替林治疗.     

5-HT1A receptor function in depression: effect of chronic amitriptyline treatment

Summary Hypothermic responses to 5-HT_1A receptor activation by the selective ligand ipsapirone (IPS) were attenuated in depressed patients as compared to controls. Chronic treatment with amitriptyline (AMI) further impaired 5-HT_1Amediated hypothermia. The results indicate a subsensitive (presynaptic) 5-HT_1A receptor and/or a defective post-receptor signalling pathway in depression and are consistent with the hypothesis that 5-HT_1A receptors are down-regulted during AMI treatment.