氟西汀合用小剂量奥氮平治疗重性抑郁障碍的疗效和安全性研究

目的 探讨氟西汀合用小剂量奥氮平治疗无明显精神病性症状的重性抑郁障碍的疗效和耐受性.方法 将73例符合DSM-Ⅳ重性抑郁障碍诊断标准的患者随机分成氟西汀合用奥氮平治疗组(下称研究组)和氟西汀治疗组(下称对照组),氟西汀(20～40mg)和奥氮平(2.5～10mg)采用可变剂量,治疗8周,采用汉密尔顿(HAMD)抑郁量表(17项)、临床疗效总评量表(CGI-SI)评定病情严重程度和疗效,采用副反应量表(TESS)评定不良反应.结果 平均起效时间研究组快于对照组(10.2±8.1)d,(14.4 ±7.9)d;t=2.3,P＜0.05].在治疗后第1,2,4,6周末HAMD减分率差异有显著性(均P＜0.05),但2组在治疗结束的第8周末HAMD减分率差异无显著性(t值为0.60,P＞0.05).结论 氟西汀合用奥氮平治疗重性抑郁障碍疗效优于单纯使用氟西汀,起效时间明显缩短.

A study on efficacy and safety of fluoxetine combined with olanzapine in the treatment of major depression

Objective To assess the efficacy and tolerance of olanzapine and fluoxetine in the treatment of major depressive disorder without psychosis.Methods 73 outpatients with major depression were randomly assigned to olanzapine group and fluoxetine treatment group for 8 weeks.Hamilton Rating Scale for Depression (HAMD),Clinical Global Impression(CGI-SI)and Treatment Emergent Side-effect Scale(TESS)were used to evaluate efficacy and adverse effects respectively before and at the ends of 1,2,4,6,8 weeks treatment.Results There was a significant reduction in the HAMD-17scores from baseline to endpoint in both groups,but the olanzapine and fluoxetine group showed effect more quickly than fluoxetine group at 1,2,4,6weeks(P＜0.05)and its side effects were similar to the fluoxetine.Conclusion This study points to the potential of olanzapine and fluoxetine as a therapeutic agent for the treatment of major depressive disorder without psychosis.