文拉法辛联合氯丙嗪治疗精神病性抑郁症的对照研究

目的　研究文拉法辛联合氯丙嗪治疗精神病性抑郁症 (PD)的疗效及其安全性。方法　文拉法辛联合氯丙嗪组 (文拉法辛组 ) 40例 ,予以文拉法辛胶囊 75mg ,Po ,bid ;阿米替林联合氯丙嗪组 (阿米替林组 ) 40例 ,予以阿米替林 75mg ,Po ,bid。两组均联合氯丙嗪 75mg ,Po ,bid。 6周为一个疗程。用汉密尔顿抑郁量表 (HAMD)、简明精神病评定量表 (BPRS)、临床疗效总评量表疾病严重程度 (CGI SI)评定疗效 ,用副反应量表 (TESS)观察副作用。结果　对抑郁症状的治疗 ,文拉法辛组显效率为 78% ,阿米替林组为 75 % ;对精神病性症状 ,两组显效率分别为 80 %、83 % ,两组疗效经Ridit分析P >0 .0 5 ,而在HAMD“焦虑 /躯体化”因子分下降方面 ,文拉法辛组更为显著 ,文拉法辛组常见不良反应为口干 (2 5 % ) ,便秘 (2 0 % ) ,视力模糊 (15 % ) ,恶心呕吐 (10 % ) ,兴奋或激越 (8% )等。结论　文拉法辛联合氯丙嗪治疗PD疗效肯定 ,不良反应较少 ,具有更高的依从性。

Venlafaxine combined with chlorpromazine in treatment of psychotic depression

Objective To study the efficacy and safety of venlafaxine combined with chlorpromazine in the treatment of psychotic depression. Methods Velafaxine combined with chlorpromazine group (venlafaxine group) of fourty patients was treated with venlafaxine 75mg,po,bid, and amitriptyline combined with chlorpromazine group (amitriptyline group) of fourty patients was treated with amitriptyline 75mg,po,bid. Both groups were treated with chlorpromazine 75mg,po,bid for 6 weeks. The scores of HAMD,BPRS,CGI-SI,and TESS were used to evaluate efficacy and adverse effects respectively before and at the ends of 1,2,4,6 weeks of treatment. Results In the treatment of depression symptoms,the significant improvement rate of Venlafaxine group was 78%,that of amitriptyline group was 75%. In the treatment of psychiatric symptom,the significant improvement rate of both group was 80% in venlafaxine group and 83% in amitriptyline group,respectively (Ridit analysis, P >0.05). However, venlafaxine group was more prominent in the reducing of anxiety/somatization factor of HAMD, Usual adverse reactions were dry mouth(25%), constipation(20%), blurred vision (15%), nausea and emesis(10%), excitation or agitation (8%), akathisia(5%) and so on in venlafaxine group. Conclusions Combination of venlafaxine with chlorpromazine is effective in treating psychotic depression,and it has less adverse reaction and well-compliance.