西酞普兰治疗抑郁症的疗效及安全性的多中心临床研究  

The efficacy and safety of citalopram in treatment of depression: a multi-center, open-label study

作　　者：司天梅[1] 舒良[1] 丁新生[2] 王崇顺[3] 王维智[4] 王晓平[5] 文有生 朱沂[7] 朱紫青[8] 老洪尧[9] 刘畅[10] 许秀峰[11] 陈佐明 范洪玉 周盛年 张聪沛 张宁[16] 屈一凡 姜凤英 高政[19] 索爱琴[20] 唐济生[21] 张晓庆[22] 钱敏才 胡学强[24] 郭田生[25] 杨友松[26] 蓝长安[27] 彭国光[28] 谭庆荣[29] 程英科 

机构地区：[1]北京大学精神卫生研究所,100083 [2]江苏省人民医院精神科 [3]上海市第一人民医院精神科 [4]哈尔滨医科大学第一医院精神科 [5]湖北省人民医院精神科 [6]武汉市精神病院精神科 [7]新疆维吾尔自治区人民医院精神科 [8]上海市精神卫生中心精神科 [9]广州市脑科医院精神科 [10]吉林大学第一医院精神科 [11]昆明医学院第一附属医院精神科 [12]河南省精神病院精神科 [13]大连市第七人民医院精神科 [14]山东省齐鲁医院精神科 [15]哈尔滨市第一专科医院精神科 [16]南京脑科医院精神科 [17]苏州市广济医院精神科 [18]北京市宣武医院神经科 [19]大连医科大学附属医院精神科 [20]河南省人民医院精神科 [21]山东省精神卫生中心精神科 [22]合肥市精神病院精神科 [23]湖州市第三医院精神科 [24]中山大学附属第三医院精神 [25]湖南省脑科医院精神科 [26]四川省人民医院精神科 [27]重庆市精神卫生中心精神科 [28]重庆医科大学附属第一医院精神科 [29]陕西省西京医院精神科 [30]天津总医院精神科

出　　处：《中华精神科杂志》2005年第4期222-226,共5页Chinese Journal of Psychiatry

摘　　要：目的系统了解西酞普兰治疗抑郁症的疗效及安全性。方法采用多中心、开放性研究,对5052例抑郁症患者(单纯抑郁症4683例,伴发躯体疾病161例,伴发强迫症112例,双相抑郁96例)进行可变剂量西酞普兰治疗,剂量为10～80mg/d,共观察8周。分别在治疗前及治疗第2,4,6,8周末以汉密尔顿抑郁量表(17项,HAMD)总分减分率评价疗效,描述性记录不良反应。结果治疗第8周末,HAMD总分平均减分率达(81.1±16.8)%。5052例中3697例(73.18%)的患者达到临床痊愈标准。伴发躯体疾病、伴发强迫症及双相抑郁患者的病情均获显著改善,后两者第8周的平均治疗剂量[(28.5±10.9)mg/d,(26.9±11.7)mg/d]均明显高于单纯抑郁症患者[(24.5±9.1)mg/d],而伴发躯体疾病患者[(22.4±7.8)mg/d]的平均治疗剂量则低于单纯抑郁症患者,差异均有统计学意义(P<0.05)。病程短、首次发作及年龄<45岁患者的疗效明显优于病程较长、反复发作及≥45岁患者。治疗过程中西酞普兰的主要不良反应为中枢神经系统和消化系统反应,症状轻微,多出现于治疗早期。结论西酞普兰安全有效,可用于治疗抑郁症或其他疾病伴发的抑郁症。Objective To explore the efficacy and safety of citalopram in treating the Chinese patients with depression. Methods A multi-center, open-label study was conducted. The subjects were 5 052 patients with depression, in which 4 683 with major depressive disorder, 161 comorbid with physical diseases, 112 with comorbid obsessive-compulsory disorder, and 96 with bipolar depression. The diagnoses were made according to the CCMD-Ⅲ criteria. The trial period lasted 8 weeks, and patients were evaluated with the Hamilton Depression Rating Scale, 17 items （HAMD） at 0, 2nd, 4th, 6th and 8th week. Side effects were classified prescriptively. Results In the 5052 cases enrolled, 42.10% were male, and the mean age was 41.0 years. A highly significant reduction on the HAMD scores were noted at weeks 2, 4, 6 and 8. The reduction on the HAMD score at weeks 8 was （81.1 ± 16.8）% , and 3 697 cases （73.18%） were clinical remission. The significant improvement was also observed in cases with comorbid physical disease, ones with comorbid OCD, and ones with bipolar depression. The efficacy was better in the acute, younger and first-episode patients than in those chronic, older and recurrent patients. The common side effects were digestive and nervous system symptoms, which occurred at the beginning of treatment and were transient. Conclusion Citalopram is a safe and effective antidepressant drug, and has better tolerability in treating depression comorbid with other disorders.

关 键 词：抑郁症 抗抑郁药 治疗结果 西酞普兰 

分 类 号：R749.4[医药卫生—神经病学与精神病学]