小剂量万拉法新治疗精神分裂症后抑郁临床观察

目的 探讨国产万拉法新(博乐欣)治疗精神分裂症后抑郁的临床疗效和不良反应。方法30例门诊入组病人均符合《中国精神障碍分类与诊断标准》第三版(CCMD-3)精神分裂症后抑郁诊断,且服用非典型抗精神病药物治疗效果欠佳。入组病人在原抗精神病药物剂量不变的基础上加服万拉法新,剂量25mg～50mg·d～1,早、晚PO,治疗时间6w。分别于治疗前及治疗2、4、6w末应用HAMD、BPRS、SANA、TESS评定疗效与副反应。结果治疗后病人自觉症状显著改善。HAMD平均总分各周下降明显,差异极显著(P<0.01),总有效率达87％。头昏(10％)、恶心(3％)、口干(6％)、嗜睡(3％)等不良反应少且轻微,无须处理,数日后自行缓解。抑郁症状改善的同时BPRS、SANS量表显示,精神病性阴性症状亦有所减轻。结论小剂量万拉法新治疗精神分裂症后抑郁有较好的疗效,不良反应轻微,药物的依从性好。

Small dosage of venlafaxine in post-schizophrenic depression

Objective To explore the clinical efficacy and side effects of domestic venlafaxine in the treatment of post-schizophrenic depression. Methods 30 enrolled out-patients met the criterion of CCMD-3 for post-schizophrenic depression and atypical anti-psychotics were not effective to them. The patients keeping used anti-psychotics' dosage were given venlafaxine 25 - 50mg/d,b. i. d. for 6 weeks. Efficacies and side effects were assessed by HAMD, BPRS, SANA, TESS before treatment and at the ends of 2nd,4th and 6th of treatment. Results After treatment: self-perceived symptoms were significantly improved, the mean score of HAMD significantly decreased on each week, difference was much significant(P<0. 01) ,total effectual rate was 87%. Side effects were fewer and milder, needn't to deal with and could improved by itself. At the same time of improvement of depressive symptoms, BPRS and SANS showed that psychotic negative symptoms lessened. Conclusion Small dosage of venlafaxine has better efficacy in post - schizophrenic depression, side effects are milder and its compliance is good.