文拉法辛缓释剂替换治疗门诊抑郁症患者观察

目的:了解文拉法辛缓释剂替换选择性5-羟色胺再摄取抑制剂类(SSRIs)疗效欠佳的门诊抑郁症患者的有效性和安全性. 方法:将符合抑郁症诊断标准并经氟西汀,舍曲林,氟伏沙明和西酞普兰4种SSRIs抗抑郁剂之一治疗量治疗6周而疗效不佳的抑郁症患者72例随机分为两组.文拉法辛组34例换用文拉法辛缓释剂,帕罗西汀组38例换用帕罗西汀,疗程6周.换药前均停原用SSRIs药物.以汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床疗效总评量表病情严重程度(CGI-SI)分别于入组时、治疗2周末、4周末、6周末评定疾病的严重程度及好转情况;以治疗中出现的症状量表(TESS)评定药物的不良反应. 结果:两组在治疗4周末及6周末时其HAMD、CGI-SI评分差异有显著性,HAMA评分则从治疗2周末起即表现出显著性差异.文拉法辛组疗效优于帕罗西汀组,两组显效率分别为70.6%和52.6%,不良反应发生率无明显差异. 结论:文拉法辛缓释剂替换经SSRIs抗抑郁剂治疗效差的门诊抑郁症患者可取得好的疗效,且安全性好.

Efficacy of venlafaxine-XR substituting selective serotonin reuptake inhibitors in treatment of major depression disorder

Objective:To study the efficacy and security of venlafaxine-XR substituting selective serotonin reuptake inhibitors(SSRIs) in treatment of depressive outpatients showing no or poor response to SSRIs. Method:72 depressive outpatients, who received one of SSRIs(fluoxetine,sertraline,fluvoxamine,citalopram)at least 6 weeks and had poor response,were randomly divided into study venlafaxine-XR group (n=34) and paroxetine group (n=38) for 6 weeks.The efficacy was measured with Hamilton depression scale (HAMD),Hamilton anxiety scale (HAMA) and clinical global impression severity of illness (CGI-SI),while the side effects were evaluated with treatment emergent symptom scale (TESS). Results:The scores of HAMD and CGI-SI in both groups decreased significantly at the end of 4th,6th week after substituting,while the scores of HAMA decreased significantly at the end of 2nd week.The efficacy in venlafaxine group was better than that in paroxetine group,and the rates of marked improvement and full recovery in venlafaxine group and paroxetine group were 70.6% and 52.6% respectively.No significant differences were found in the side effects between two groups. Conclusion:Venlafaxine-XR may be effective and safe in SSRI-resistant depressive patients.