文拉法辛联合奋乃静治疗伴有精神病性症状的抑郁症对照研究

目的 探讨文拉法辛(venlafaxine)联合奋乃静治疗伴有精神病性症状抑郁症的疗效及其安全性。方法 将64例伴有精神病性症状的抑郁症随机分配至研究组和对照组各32例。研究组予以文拉法辛联合奋乃静治疗,对照组予以阿米替林联合奋乃静治疗。文拉法辛及阿米替林的治疗剂量均为100～200mg/d,奋乃静为12～24mg/d,观察时间均为6周。疗效评定采用HAMD、BPRS及CGI。安全性评价采用TESS、实验室检查及体检。结果 治疗第6周末,对抑郁症状,研究组显效率为65.6％,有效率为87.5％,与对照组的59.4％及84.4％相近;对精神症状,研究组显效率为68.8％,有效率为87.5％,亦与对照组的68.8％及90.6％相近,差别均无显著性意义(P>0.05)。研究组常见不良反应为恶心呕吐、口干、便秘、出汗及静坐不能等,不良反应程度均轻微,病人依从性好。结论 文拉法辛联合奋乃静治疗伴有精神病性症状的抑郁症疗效肯定,且不良反应较少,病人依从性好。

Comparison study of venlafaxine combined with perphenazine in treatment of psychotic depression

Objective To study the efficacy and safety of venlafaxine combined with perphenazine in treatment of psychotic depression. Methods 64 patients with psychotic depression were divided into two groups. Venlafaxine combined with perphenazine group(the study group) of 32 patients was treated with venlafaxine 150 - 300mg/d, po. Amitriptyline combined with perphenazine group(the control group) of 32 patients was treated with amitriptyline 100 -200mg,po. Both groups were treated with perphenazine 12 - 24mg/d,po. The duration of treatment was 6 week. HAMD ,BPRS and CGI were adopted to evaluate the efficacy. Safety was evaluated by TESS, laboratory and physical examination. Results After 6 week treatment,the results based on the reduction rate of HAMD showed the study group was effective on depressive symptoms, the significant improvement rate waw 65.6% ,the response rate was 87. 5%. The significant improvement rate and the response rate of the control group was 59.4% and 84.4%. The results based on the reduction rate of BPRS showed the study group was effective on psychotic symptoms,the significant improvement rate was 68. 8% ,the response rate was 87.5%. The significant improvement rate and the response rate of the control group was 68.8% and 90.6% respectively. There were no significant differences between the two groups ( P > 0.05). Usual adverse reactions were nausea, and emesis, dry mouth, constipation , perspire, akathisia and so on in the study group, but the degree of adverse reactions were mild. Conclusions Venlafaxine combined with perphenazine is effective in treating psychotic depression, and it has less adverse reactions and well - compliance.