帕罗西汀替换三环类抗抑郁剂治疗抑郁症对照研究

目的：了解帕罗西汀替换三环类抗抑郁剂(TCAs)治疗抑郁症的有效性和安全性。方法：将经TCAs足量治疗6周疗效达好转及以下的、符合反复发作抑郁症诊断标准的患者随机分为帕罗西汀组和三环类组。帕罗西汀组渐停TCAs，渐增帕罗西汀治疗，剂量20～40mg／d；三环类组继续使用TCAs150～250mg／d治疗。用Hamilton抑郁量表(HAMD)、大体评定量表(GAS)、临床疗效总评量表病情严重程度(GGI-SI)，分别于人组时，治疗1周末、2周末、4周末、8周末评定其病情变化；副反应量表(TESS)评定不良反应。结果：与入组时比较，帕罗西汀组治疗2周末各种量表评分差异即有显著性；三环类组治疗4周末HAMD、GAS评分差异有显著性，CGI—SI评分治疗8周末差异有显著性。帕罗西汀组治疗后HAMD、GAS、CGI—SI减分明显多于三环类组，帕罗西汀组不良反应发生率显著少于三环类组。结论：帕罗西汀替换TCAs治疗效差的抑郁症安全有效，可在临床上试用。

A comparative study of paroxetine versus tricyclic antidepressants for depression

Objective:To investigate the clinical efficacy and safety of paroxetine replacing tricyclic antidepressants (TCAs) in the treatment of depression. Method:The patients diagnosed as recurrent depression which received 6-week treatment of TCAs with enough dose,and reported being improved or worse,were randomly assigned into two groups.The subjects in intervention group stopped receiving TCAs slowly, and meanwhile received paroxetine step by step.The subjects in control group still received TCAs.The efficacy of all subjects was assessed from baseline to the end of the first,second,fourth and the eighth week respectively, with HAMD,GAS,CGI-SI.Side effects were evaluated with TESS. Results:There were significant differences in the scores of HAMD,GAS,CGI-SI at the end of two weeks treatment in the intervention group,compared to the beginning of the intervention.There were significant differences in the scores of HAMD,GAS at the end of four weeks treatment in the control group,CGI-SI at the end of eight weeks treatment. Conclusion:Paroxetine replacing TCAs in the treatment of depression is safe and effective.