帕罗西汀合并利培酮治疗难治性抑郁症的疗效分析

目的:探讨小剂量利培酮与帕罗西汀治疗难治性抑郁症的辅助效果.方法:将98例难治性抑郁症患者随机分为2组:①帕罗西汀合并利培酮组(以下简称合并利培酮组):在帕罗西汀(20 mg/d)治疗的同时合并应用利培酮(0.5～2.0mg/d).②帕罗西汀组:单用帕罗西汀(20mg/d)治疗.两组持续治疗观察期均为4周.于入组前、入组后第1,2,4周末分别应用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及副反应量表进行评定.结果:①治疗第2,4周末,两组间HAMD、HAMA总分及减分率的差异有统计学意义(P＜0.05或P＜0.01).②合并利培酮组的总有效率为66％,痊愈和显效率占52％.帕罗西汀组的总有效率为27％,痊愈和显效率占19％.两组间的差异有统计学意义(P＜0.05).结论帕罗西汀合并小剂量利培酮治疗难治性抑郁症的疗效优于单用帕罗西汀,在临床治疗中可选用.

Effects of Risperidone Augmentation to Paroxetine on the Treatment - Resistant Depression

Objective:To explore the effects of low-dose risperidone augmentation to paroxetine on the treatment-resistant depression.Method: 98 patients with the treatment-resistant depression were randomly assigned to the two groups:a low dose(0.5～2.0 mg/d) of risperidone plus paroxetine group and paroxetine group.Two groups were assessed with Hamilton Depression Scale(HAMD),Hamihon Anxiety Scale(HAMA),and Treatment Emergent Symptom(TESS) at baseline and every one or two weeks subsequently,The study lasted for 4 weeks.Results:①The 48 combining-treatment patients included 25males and 23females with the average age of(41±12) years.The 50 mono-treatment patients included 26 males and 24～males with the average age of(42±12)years.②There were significant differences on the scores of HAMD and HAMA between the two groups at two weeks and the endpoint of treatment(P<0.05).③In the augmented treatment group,66%responded,while 27%responded in mono-therapy group.Risperidone augmentation produced greater improvement than paroxetine mono-therapy(P<0.05).Conclusion:Risperidone may be a useful adjunct to paroxetine in treatment of refractory depression.