吸烟与氟西汀疗效和副作用关系的初步研究

目的：探讨吸烟对氟西汀治疗剂量，疗效和副作用的影响。方法：对98例符合CCMS－2－R和DSM－Ⅲ诊断标准的抑郁症患者，用HAMD和HAMA减分率评价临床有效性，用TESS分值评价安全性。对每日吸10支以上烟，每日吸10支以下烟和不吸烟组进行氟西汀治疗剂量，疗效和副作用的比较。结果：在氟西汀平均日剂量相同的情况下，吸10支以上烟组疗效极显著差于吸10支以下烟和不吸烟组（P＜0．01），副作 显著轻于吸10支以下烟和不吸烟组（P＜0．01），每日吸10支以下烟组疗效显著差于不吸烟组（P＜0．05），副作用两组无显著性差异（P＞0．05），结论：抑郁症患者在氟西汀治疗期间不吸烟可以减少氟西汀治疗剂量和提高疗效。临床医生在评价氟西汀疗效和副作用时，应注意到吸烟这一因素的影响。

Relationship among smoking, therapeutic efficacy and side effects of fluoxetine in depression.

Objective To study the influence of smoking on dosage, therapeutic and side effects of fiuoxetine in depressive patients. Methods 98 inpatients who meet the criteria of depression in CCMD - 2 - R and DSM - III were evaluated with HAMD, KAMA and TESS. The dosage, therapeutic efficacy and side effects of fiuoxetine in smoking patients were compared with nonsmoking patients. Results Under the same dosage of fiuoxetine, the therapeutic efficacy was significantly better in no smoking patients than that in smoking patients, while the side effects of fiuoxetine was significantly less in smoking patients than nosmoking patients. Conclusion Smoking may reduce the effects of fiuoxetine and enhance the side effects of fiuoxetine, should be forbidden'in depressive patients. When therapeutic and side effects of fiuoxetine are evaluatled smoking should be considered.