奥氮平合并氟西汀治疗抑郁症的疗效及安全性分析

目的 观察奥氮平合并氟西汀治疗抑郁症的疗效和安全性。方法 将76例符合中国精神疾病分类方案与诊断标准第3版抑郁发作诊断标准的患者随机分为两组：氟西汀组38例，予氟西汀2～40mg／d，口服，实际完成37例；合并奥氮平组38例，予氟西汀20～40mg／d，口服，合并奥氮平2．5～10mg／d，口服，实际完成36例，均治疗观察8周。结果 两组患者汉密尔顿抑郁量表（HAND）总分及减分率的差异在治疗第4天就有统计学意义，而且这种差异在每个访视期均存在（P〈0．05或0．01）；合并奥氮平组在治疗第1、2、4周末的有效率均较氟西汀组高P〈0．05或0．01）；两组治疗8周末有效率（89．2％、86．5％）和痊愈率（75．0％、64．9％）差异无统计学意义（均P〉0．05）；两组不良反应程度均较轻，总体发生率的差异无统计学意义（均P〉0．05）。结论 奥氮平合并氟西汀治疗抑郁症是一种快速、有效，安全治疗的新方法。

Efficacy and safety of olanzapine combined with fluoxetine in treatment of depression

Objective To explore the efficacy and safety of olanzapine combined with fluoxetine in the treatment of depression. Methods A 8-week study was conducted with 76 patients who met the diagnostic criteria for depression. Subjects were randomly assigned to two groups: fluoxetine (20-40 mg.d-1) alone and olanzapine (2.5-10 mg.d-1) plus fluoxetine (20-40 mg.d-1). They were evaluated with Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Treatment Emergent Symptom Scale (TESS) at baseline, 4th day, 1 wk, 2 wk, 4 wk and 8 wk subsequently. Results (1) There were significant differences on the total scores and reduction rates of HAMD between two groups in every Interview(P<0.01or<0.05). (2) The combination group had greater reduction in depressive and anxiety symptoms than that in fluoxetine group. (3) The response rate in combination group was higher than that of fluoxetine group at 1 wk, 2 wk and 4 wk(P<0.01or<0.05). There were no significant differences in response and remission rates between combination group (89.2 % and 75 %) and fluoxetine group. (86.5 % and 64.9 %)(P>0.05) (4) In combination group 53 % of patients showed mild side effects, while that was 43% in fluoxetine group(P>0.05).Weight gain and increased appetite occurred more frequently in combination group, while decreased appetite occurred in fluoxetine group. Conclusion The combination of olanzapine with fluoxetine demonstrates a rapid, effective and safe antidepressant action.