文拉法辛替换选择性5羟色胺再摄取抑制剂(SSRI)与SSRI合并瑞波西汀治疗SSRI抵抗性抑郁症的疗效比较  

Comparison of the Efficacy between Venlafaxine and SSRI Plus Reboxetine in Pateients with SSRI-resistant Depression

作　　者：寻知元[1] 张国双[1] 江芮[1] 吕浩[1] 

机构地区：[1]天津市安定医院精神科,天津300222

出　　处：《中国慢性病预防与控制》2012年第6期656-658,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的比较文拉法辛替换5羟色胺再摄取抑制剂(SSRI)与SSRI合并瑞波西汀治疗SSRI抵抗性抑郁症的疗效和安全性。方法将93例SSRI抵抗性抑郁症患者随机分为两组,分别予文拉法辛替换SSRI治疗(n=47)和加用瑞波西汀治疗(n=46)。在治疗前及治疗第1、2、4、8周末采用汉密尔顿抑郁量表(HAMD)评分并计算减分率、显效率,评定临床疗效。采用不良反应量表(TESS)评定药物的安全性。结果在治疗观察结束时,两组的HAMD评分均较治疗前有显著的下降,差异有统计学意义(P<0.05)。文拉法辛组与合并瑞波西汀组的显效率分别为70.2%,77.8%,差异无统计学意义(χ2=0.68,P>0.05)。合并瑞波西汀起效较换用文拉法辛快2周。两组不良反应发生率分别为27.66%和28.89%,差异无统计学意义(χ2=0.017,P>0.05)。结论换用文拉法辛与合并瑞波西汀均对治疗SSRI抵抗性抑郁症有良好的疗效,而文拉法辛替换SSRI治疗较合并瑞波西汀可能更有临床实践中的优势。Objective To compare the efficacy and safety between venlafaxine and SSRI combined with reboxetine in patients with SSRI-resistant depression. Methods Ninty-three patients with SSRI-resistant depression were randomly divided into two groups and respectively treated with venlafaxine or SSRI combined with reboxetine. At the beginning and at the end of the hh, 2th and 4th and 8th week, the efficacy was evaluated with the scale of Hamilton Rating Scale for Depression（HAMD）, reducing score rate, the rate of marked improvement and full recovery. The safety was evaluated with the treatment emergent symptom scale （TESS）. Results By the end of treatment, the scores of HAMD in both groups decreased significantly. The rates of marked improvement in venlafaxine group and combined treatment group were 70.2% and 77.8% respectively, there was no significant difference of efficacy between the two groups （~2=0.68, P〉0.05）. The time of initial effect in the combined treatment group was rapider than venlafaxine group at two weeks. The rate of side effects of two groups were 27.66% and 28.89% （X2=0.017, P〉0.05 ）. Conclusion The venlafaxine substituting SSRI and SSRI combined with reboxetine appears to have the same good effect in patients with SSRI-resistant depression. Venlafaxine substituting SSRI is more suitable for clinical practice than SSRI combined with reboxetine.

关 键 词：抑郁症 抵抗性抑郁 文拉法辛 瑞波西汀 

分 类 号：R749.05[医药卫生—神经病学与精神病学]