文拉法辛治疗阿片类物质依赖伴抑郁患者复发的影响  

THE EFFECT OF ANTIDEPRESSANT VENLAFAXINE ON RELAPSE OF OPIOID DEPENDENCE WITH DEPRESSION

作　　者：张莉[1] 石元洪 李毅 刘学兵[1] 

机构地区：[1]武汉市精神卫生中心戒毒门诊,武汉430022 [2]扬州大学临床医学院苏北人民医院临床心理科,扬州225001

出　　处：《中国药物依赖性杂志》2015年第3期193-196,共4页Chinese Journal of Drug Dependence

基　　金：扬州市重点人才基金项目;扬州英才培育计划基金项目

摘　　要：目的:前瞻性探索文拉法辛治疗对阿片类物质依赖伴抑郁患者复发的影响。方法:根据抑郁和阿片类物质依赖发生的先后次序以及是否应用文拉法辛将患者分为A1、A2、B1和B2组,其中A组患者抑郁后伴发物质依赖,B组患者物质依赖后伴发抑郁;A1、B1组患者给予文拉法辛治疗,A2、B2组患者不给文拉法辛。确定复发时间,采用贝克抑郁量表(BDI-21)评定患者抑郁症状,随访观察12周。结果:共124例患者完成实验。与A2组相比,A1组患者复发时间较长,BDI评分较低(P<0.05);在第8周内,A1组患者复发率明显低于其他组(P<0.05)。结论:文拉法辛治疗可能延长或降低抑郁伴发阿片类物质依赖患者的复发时间或复发率,改善其抑郁症状;但抗抑郁药治疗对阿片类物质依赖后抑郁患者无论是复发还是抑郁症状的改善均作用有限。Obective To study the effect of venlafaxine on relapse of opioid dependence （OD） with depression. Methods： According to depression occurred before or after OD and treatment by venlafaxine or placebo, the OD patients were divided into 4 group：group A1 （depression before OD, DPOD; with venlafaxine）, group A2（DPOD; no venlafaxine）, group B1 （depression after OD, DAOD; venlafaxine）, group B2 （DAOD; no venlafaxine）. The time to relapse was determined and depressive symptom was evaluated with Beck Depression Inventory （BDI）. The investigation lasted for 12 weeks. Results：A total of 124 patients were involved in the data analysis. Compared with group A2, the time to relapse was longer and the value of BDI was lower in group A1 （ P 〈 0.05 ）. The relapse rate of group A1 was lower than that of other groups at the 8th week （ P 〈 0.05 ）. Conclusion ： Venlafaxine treatment may decrease the relapse of OD and the symptoms of depression for DPOD. However, it was not work for DAOD.

关 键 词：阿片类物质依赖 抑郁 抗抑郁药治疗 复发 

分 类 号：R749.69[医药卫生—神经病学与精神病学]