帕罗西汀联合喹硫平治疗难治性抑郁症对照研究

目的探讨帕罗西汀联合喹硫平治疗难治性抑郁症的临床疗效和安全性。方法将60例难治性抑郁症患者随机分为两组，每组30例，两组均口服帕罗西汀治疗，在此基础上研究组联合喹硫平治疗，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临床疗效，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显著性下降（P〈0．01），同期研究组评分较对照组下降更显著（P〈0．01），减分率较对照组升高更显著（P〈0．01）；治疗8周末，研究组显效率50．0％、有效率73．3％，对照组分别为23．3％、40．0％，研究组显著高于对照组（x2=4．59、6．79，P〈0．05或0．01）。两组不良反应程度均较轻，同期副反应量表评分差异无显著性（P〉0．05）。结论喹硫平对治疗难治性抑郁症具有增效作用，且不增加不良反应；帕罗西汀联合喹硫平治疗难治性抑郁症疗效显著，起效快，安全性高，依从性好，显著优于单用帕罗西汀治疗。

A control study of paroxetine combined with quetiapine in treatment-resistant depression

Objective To explore the efficacy and safety of paroxetine combined with quetiapine in treat- ment-resistant depression （TRD）. Methods Sixty TRD patients were randomly assigned to two groups of 30 one each, both groups took orally paroxetine, on that basis research group was plus quetiapine for 8 week. At baseline and at the end of the 1st, 2nd, 4th and 8th week efficacies were assessed with the Hamilton Depression Scale （HAMD） and adverse reactions with the Treatment Emergent Symptom Scale （TESS）. Results After treatment the HAMD scores of both groups lowered more significantly compared with pre- treatment （P〈0.01）, so did contemporaneous scores （P〈0.01） and score-reducing rate increased more significantly （P〈0.01） in research than in control group; at the end of the 8th week, obvious effective and effective rates were 50.0% and 73.3% in research and 23.3% and 40.0% in control group respectively, the former were significantly higher than the latter （x2=4.59, 6.79, P〈0.05 or 0.01）. Adverse reac- tions of both groups were mild, there were no significant differences in contemporaneous TESS scores （P〉0.05）. Conclusion Quetiapine has a synergistic action in TRD and doesn＇t increase adverse reac- tions; paroxetine combined with quetiapine has an evident effect in TRD, takes effect more rapidly, has higher safety and better compliance compared with single paroxetine.