米氮平与氟西汀治疗抑郁症的对照研究

目的 评价米氮平与氟西汀治疗抑郁症的有效性和安全性。方法 采用CCMD-3关于抑郁症的诊断标准,对分别接受米氮平和氟西汀的76例抑郁症患者进行为期6 w的观察,并应用HAMD和TESS量表评估和比较这两种药物治疗抑郁症的疗效和安全性。结果 经过6 w的治疗,米氮平组有效率和治愈率分别为89.5％和63.2％,与氟西汀组(92.1％,57.9％)无显著性差异(P>0.05)。而两组内HAMD总分治疗前后比较差异均有显著意义(P<0.05)。治疗1 w后,米氮平组的有效率(63.2％)高于氟西汀组(28.9％),差异有显著性(P<0.05)。与氟西汀组相比,米氮平组嗜睡发生率较高,氟西汀组口干、疲乏、兴奋或激越等副反应发生率高于米氮平组,差异均有显著性(P<0.05)。不同起始剂量米氮平和氟西汀的HAMD减分率无显著差异(P>0.05),但起始量15 mg/d的米氮平的嗜唾和眩晕或头昏副反应发生率低于30 mg/d者(P<0.05)。结论 米氮平是一种安全、有效的新型抗抑郁药物,起效较快,且有改善焦虑及睡眠作用,治疗宜从低剂量开始。

The control study of mirtazapine versus fluoxetine in the reatment of depression

Objective: To evaluate the therapeutic effect and safety of Remeron and Fluoxetine in treatment of depression. Methods: Seventy-six depression patients according to CCMD-3 criteria were enrolled in this study. Thirty-eight patients taking Remeron (15 -30 mg/d) .and another 38 patients having Fluoxetine (10-20 mg/d) for six weeks. All the patients were evaluated with HAMD and TESS. Artidepressive effect was compared between 2 drugs. Results: At the end of six weeks of treatment, there were no significant difference between the effective rates and cure rates of Rerneron group (89. 5% , 63. 2% ) and those of Fluoxetine group (92.1%, 57. 9% ) (P > 0. 05). However, at the end of one week, the effective rate of Remeron group (63.2% ) was significantly higher than that of Flouoxetine group (28. 9% ) (P <0. 05). The scores of HAMD scale after six weeks of treatment were significandy lower than those before treatment both in Remeron and Fluoxetine groups, respectively ( P < 0. 05 ). The frequency of somnolence and dizziness in Remeron group was much higher than that of Fluoxetine group, and the frequencies of dry mouth, fatigue, excitation or agitation of Fluoxetine group were significandy higher than those of Remeron group (P < 0. 05). There was no significant difference in reduction of HAMD between 15 mg/d and 30mg/d subgroups of Remeron (P>0.05). However, the frequency of somnolence in 15 mg/d subgroup of Remeron was significandy lower than that of 30 mg/d subgroup (P < 0. 05). Conclusion: Remeron is a safe, effective and novel antidepres-sant. With rapidonset of response and effect on improving anxiety and insomnia, low stanting dose is suggested.