艾司西酞普兰与帕罗西汀治疗精神分裂症后抑郁障碍对照研究

目的探讨艾司西酞普兰与帕罗西汀治疗精神分裂症后抑郁障碍的临床疗效和安全性。方法将72例精神分裂症后抑郁障碍患者随机分为两组，研究组37例，对照组35例，两组均维持原用抗精神病药物治疗，在此基础上研究组口服艾司西酞普兰治疗，对照组口服帕罗西汀治疗，观察8周。于治疗前及治疗1周、2周、4周、8周末采用汉密顿抑郁量表评定抑郁状况，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评分均较治疗前有显著下降（P〈0．01），但研究组治疗第1周末较对照组下降更显著（P〈0．01），其他时段评分两组比较差异均无显著性（P〉0．05）；治疗8周末，研究组有效率为81．1％，对照组为72．3％，两组比较差异无显著性（x2=0．48，P〉o．05）；两组不良反应均较轻微，总体不良反应发生率比较差异无显著性（x2=1．34，P〉0．05），但研究组性功能障碍发生率显著低于对照组（x2=4．58，P〈0．05）。结论艾司西酞普兰与帕罗西汀均能显著改善精神分裂症后抑郁障碍患者的抑郁症状，总体疗效相当，但艾司西酞普兰起效更快，对性功能影响较小，安全性更高，依从性更好。

A control study of escitalopram vs.paroxetine in post-schizophrenic depression

Objective to explore the clinical effect and safety of escitalopram and paroxetine in post-schizo- phrenic depression （PSD）. Methods Seventy-two PSD patients were randomized to research （n =37） and control group （n = 35）, both groups maintained original antipsychotics treatment, on that basis research group took orally escitalopram and control did paroxetine for 8 weeks. At baseline and at the end of the 1st, 2nd, 4th and 8th week depression condition was assessed with the Hamilton Depression Rating Scale （HAMD） and adverse reactions were did with the Treatment Emergent Symptom Scale （TESS）. Results After treatment the HAMD scores of both groups lowered more significantly compared with pretreatment （P〈0.01）, but so did that in research than in control group at the end of the 1st week （P〈0.01）, there were no significant group differences in other periods （P〉0.05） ; at the end of the 8th week effective rates were respectively 81.1% in research and 72.3% in control group, which showed no significant difference （x2=0.48, P〉0.05） ; adverse reactions of both groups were mild, there were no significant group differ- ences in the incidence of total adverse reactions （x2=1.34, P〉0.05）, but the incidence of sexual dysfunc- tion was significantly lower in research than in control group （x2=4.58, P〈0.05）. Conclusion Both es- citaloprarn and paroxetine could improve depressive symptoms of PSD patients and have equivalent total ef- ficacy, but the former takes effect more rapidly, has less influence on sexual function, higher safety and better compliance.