米氮平治疗神经性厌食症的疗效对照研究

目的：观察米氮平对神经性厌食症的疗效。方法：42例符合CCMD-3神经性厌食症患者被随机分成2组，分别给予米氮平和5-羟色胺再摄取抑制剂（SSRIs）治疗12周，而后随访12周。比较患者治疗前后的体重变化、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评分及药物不良反应。结果：共38例患者完成治疗全过程，其中米氮平组20例，SSRIs组18例。在治疗6周时，米氮平组的体重增加大于SSRIs组，差异有显著性（P〈0．01）；治疗12周时，两组体重增加值差异没有显著性。治疗后两组HAMD和HAMA评分均明显减低（P〈0．01），但两组间差异无显著性（P〉0．05）。两组均未出现严重的药物不良反应，主要不良反应SSRIs组为胃肠道不适，米氮平有嗜睡、体重增加等。结论：米氮平能明显提高神经性厌食症患者的食欲和体重，改善焦虑抑郁情绪，依从性好，起效时间早于SSRIs，值得在临床上选用。

Effect of Mirtazapine in Patients with Anorexia Nervosa

Objective:To investigate the efficacy of mirtazapine in patients with anorexia nervosa.Methods: A randomized,controlled study was undertaken in 42 patients with anorexia nervosa.Subjects were treated with mir- tazapine or selective serotonin reuptake inhibitor(SSRIs)for 12 weeks and followed up to 12 weeks.The clinical out- come measures included body weight,Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and the side effects of medications.Results:38 subjects completed the trial,20 in mirtazapine group,18 in SSRIs group. The weight gain in mirtazapine group was significantly more that that in SSRIs group at week 6 but the difference was not significant at week 12.The scores of HAMD and HAMA at endpoint were significantly lower than those at base- line(P<0.01),but the difference between groups was not statistically significant(P>0.05).No severe adverse events were observed in both groups.Common side effects of SSRIs were gastroenterological discomfort,while those of mir- tazapine included somnolence and weight gain.Conclusion:Mirtazapine can improve appetite and weight gain in pa- tients with anorexia nervosa in addition to relieve anxiety and depression.It is well tolerated and has ealier onset of effect than SSRIS.