帕罗西汀治疗酒依赖临床疗效研究

目的：探讨帕罗西汀治疗酒依赖患者的疗效与安全性。方法：采用临床开放研究，将68例酒依赖患者随机入组，治疗24周，在不同治疗时段采用密执根酒精依赖调查表（MAST）、饮酒渴求度、饮酒量调查表、17项汉密尔顿抑郁量表（Hamilton Depression Scale，HAMD-17）、汉密尔顿焦虑量表（Hamdton Anxieg Scale，HAMA）进行测试。结果：观察期内帕罗西汀组的饮酒渴求度，在治疗的第8、16、24周，明显低于对照组，比较差异有显著性fP值均〈0，05）；帕罗西汀组的酒精消耗量在治疗的第8、16、24周，较对照组显著减少，差异有统计学意A（P值均〈0．05）；帕罗西汀组HAMD-17评分，在治疗的第6、8、16、24周比较差异有显著性（P值均〈O．05）；帕罗西汀组的FLAMA评分，在治疗的第2、4、8周，明显低于对照组，比较差异有显著性（P值均〈0．05）；复饮患者纳曲酮组和对照组分别有6／31例、12／29例，差异有显著性（P值〈0．05）；不良事件记录显示帕罗西汀比较常见的不良反应主要为消化道反应（30／34）和乏力、嗜睡、头疼等神经系统副作用（3／34）。结论：帕罗西汀能有效降低酒依赖患者的心理渴求、酒精消耗和复饮风险，同时也能缓解酗酒导致的抑郁、焦虑症状。帕罗西汀的不良反应程度较轻，患者多可耐受，是一种安全有效的酒依赖治疗药物。

Clinical efficacy of paroxetine in the treatment of alcohol dependence

Objective ： To explore the therapeutic efects and safety of paroxetine for treating patients with alcohol dependence.Methods：A total of 68 outpatients with alcohol dependence were randomly assigned to paroxetine group treated with paroxetine or control group for 24 weeks. The Michigan Alcohol Screening（MAST）,Alcohol Craving Scale,Drinking Recorder Scale, Hamilton Depression Scale （HAMD-17）, Hamilton Anxiety Scale （HAMA） were used to evaluate the effects and safety of paroxetine. Results： The scores of Alcohol of Craving Scale in paroxetine group at the 8th, 16th and 24th week were significantly lower than control group, showing significant difference when compared with those of the control group （P〈0.05）; alcohol consumption in paroxetine group at the 8th, 16th and 24th week were significantly lower than those in control group （P〈0.05）; the scores of HAMD-17 in paroxetine group at the 6th, 8th, 16th and 24th week were significantly lower than those in control group （P〈0.05）; the scores of HAMA in paroxetine group at the 2nd,4th and 8th week were significantly lower than those in control group （P〈0.05）; relapse to drink also showed significant difference between the two groups （6/31,10/34）.The main adverse effects of paroxetine were digestive tract reaction （10/34）, fatigue, drowsiness, headache and other nervous system side effects （3/34）.Conclusion： Paroxetine can effectively inhibit alcohol craving, decrease alcohol consumption and incidence of relapse in alcohol dependent patients. It can also relieve alcohol abuse-induced depressed and anxiety symptoms and the adverse effects are slight and transitory. Paroxetine is effective and safe for the treatment of alcohol dependant patients.