米氮平与万拉法新治疗精神分裂症后抑郁对照研究

目的探讨米氮平与万拉法新治疗精神分裂症后抑郁障碍的临床疗效及安全性。方法将59例精神分裂症后抑郁障碍患者随机分为研究组31例，对照组28例，两组均维持原用抗精神病药物治疗的种类、剂量、用法不变，在此基础上研究组口服米氮平治疗，对照组口服万拉法新治疗。观察4周。于治疗前及治疗2周、4周末采用汉密顿抑郁量表评定抑郁状况，简明精神病量表评定精神症状，副反应量表评定不良反应。结果治疗后两组汉密顿抑郁量表总分、各因子分及简明精神病量表总分均较治疗前有显著下降（P〈0．01）；治疗4周末，研究组显效率70．97％、总有效率93．55％，对照组分别为71．43％、92．86％，两组差异均无显著性（P〉0．05）。两组不良反应主要表现为体重增加、口干、出汗、恶心、头晕等，且程度均轻微。结论精神分裂症后抑郁障碍患者在应用抗精神病药物治疗的基础上，联合新型抗抑郁剂米氮平与万拉法新治疗起效快、疗效显著、安全性高、依从性好。

A control study of mirtazapine vs. venlafaxine in post-schizophrenic depression

Objective To explore the clinical efficacy and safety of mirtazapine vs. venlafaxine in post- schizophrenic depression （PSD）. Methods Fifty-nine PSD patients were randomized to research （n= 31） and control group （n= 28）, both groups maintained kinds, dosage and usage of original used antipsychotics, the research group was plus oral mirtazapine and the control group plus venlafaxine for 4 weeks. De- pression status was assessed with the Hanmilton Depression Scale （HAMD）, mental symptoms with the Brief Psychiatric Rating Scale （BPRS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） bofere treatment and at the end of the 2nd and 4th week. Results After treatment, the total and each factor scores of the HAMD and the toatl score of the BPRS of both groups lowered more significantly compared with pretreatment （P〈0.01） ; at the end of the 4th week, obvious and total effective rates were 70.97% and 93.55% in the research and 71.43% and 92.86% in the control group respectively, which showed no significant differences （P〉 0.05）. Adverse raections of both groups were mild and mainly weight increase, dry mouth, perspiration, nausea, dizziness and so on. Conclusion On the basis of antip- sychotic medication, the combination with mirtazapine or venlafaxine takes effect more rapidly and has an evident effect, higher safety and better compliance in post-schizophrenic depression.