氟西汀和曲唑酮的抗焦虑作用  

Efficacy of Fluoxetine and Trazodone in Treatment of Anxiety

作　　者：吴恺[1] 胡夏生[1] 罗盛[1] 

机构地区：[1]卫生部北京医院神经内科,北京100730

出　　处：《中国神经免疫学和神经病学杂志》2000年第2期111-115,共5页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的　观察氟西汀 (fluoxetine)和曲唑酮 (trazodone)对焦虑症状的改善作用。方法　选择符合CCMD II R抑郁症诊断标准、伴有焦虑或单纯广泛性焦虑的病例共 148例 ,按就诊顺序随机分为 4组。一组单用氟西汀2 0mg/d ,一组用氟西汀 2 0mg/d加曲唑酮 50～ 10 0mg/d ,一组用氟西汀 2 0mg/d加罗拉 1 5mg/d ,一组用安慰剂加少量安定或 10g/dL水化氯醛。观察 8周。结果　氟西汀能有效的改善焦虑症状 ,但疗效出现较晚 ,第 6周才显示抗焦虑效果。加用曲唑酮或罗拉能加强氟西汀的抗焦虑作用 ,同时能缓解氟西汀在用药早期加重焦虑和影响睡眠的副作用。结论　氟西汀有抗焦虑疗效。用氟西汀抗焦虑的早期加用曲唑酮或罗拉有利于病情的缓解和提高患者的治疗依从性。Objective To determine whether fluoxetine and trazodone could be effective in the treatment of anxiety.Methods 148 subjects who met CCMD II R creteria for depression and anxiety were randomly assigned to fluoxetine,fluoxetine plus trazodone and fluoxetine plus lorazepame for 8 weeks.Efficacy was assessed with the Hamilton Rating Scale for Anxiety(HAMA) and Clinical Global Impressions scale. Results Among 148 subjects,fluoxetine plus trazodone、fluoxetine plus lorazepame were significantly superior ( P <0.05)to placebo on the HAMA total score begining at week 3(fluoxetine plus trazodone and fluoxetine plus lorazepame groups) and week 6 (fluoxetine group) and continuing to the end of the study.HAMA response rate was significantly higher ( P <0.05) at week 3,4,6 and 8 with fluoxetine plus trazodone and fluoxetine plus lorazopame ,and at week 6 and 8 with fluoxetine than with placebo respectively.Remission rate was significantly higher ( P <0.05) with fluoxetine plus trazzodone and fluoxetine plus lorazepame than with fluoxetine and with placebo.Major adverse events were anxiety and insomnia in fluoxetine group,daily sleepy in fluoxetine plus trazodone and fluoxetine plus lorazepame groups. Conclution Fluoxetine and trazodone are effective and well tolerated for the treatment of anxiety,but the effect of trazodone begins earlier than fluoxetine.

关 键 词：氯西汀 曲唑酮 焦虑症 药物治疗 

分 类 号：R749.720.5[医药卫生—神经病学与精神病学]