摘要
目的探讨氯氮平联合氟西汀治疗精神分裂症伴抑郁症状的临床疗效及安全性。方法将80例服用氯氮平治疗2mo后伴有抑郁症状的精神分裂症患者随机分为两组各40例,两组均维持原氯氮平治疗剂量不变,均给予支持性心理治疗,研究组联合氟西汀治疗,观察6w。于治疗前及治疗2w、4w、6w末采用简明精神病量表、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6w末研究组抑郁症状总有效率为82.5%,对照组为32.5%,两组差异有极显著性(χ2=21.04,P<0.01)。同期研究组汉密顿抑郁量表及简明精神病量表评分均较对照组下降显著(P均<0.01～0.05)。副反应量表评分,研究组治疗2w末较治疗前显著升高,且显著高于对照组(P<0.01),4w、6w末与治疗前及同期对照组评分比较均无显著性差异(P>0.05)。结论氯氮平联合氟西汀治疗能显著改善精神分裂症的抑郁情绪,同时对精神症状的改善具有协同作用,且不加重氯氮平的不良反应,不影响治疗依从性。
Objective To explore the curative effects and safety of clozapine plus fluoxetine in schizophrenia with depressive symptoms. Methods Eighty patients who accompanied with depressive symptoms after 2 month clozapine treatment were randomly divided into research and control group（both n=40）,both groups maintained clozapine and supportive psychotherapy, and the research was plus fluoxetine, for 6 weeks. Curative effects were assessed with the Brief Psychiatric Rating Scale（BPRS） and the Hamilton Depression Scale（HAMD） and adverse reactions with Treatment Emergent Symptom Scale（TESS） before treatment and at the ends of week 2,4 and 6 treatment. Results At the end of week 6, total effective rates of depressive symptoms were 82.5% in the research and 32.5% in the control group respectively, which showed significant difference（P〈0.01）. Synchronization scores of both the BPRS and HAMD lowered more significantly in the research than in the control group（all P〈0.01～0.05）. The score the TESS was significantly higher at the end of week 2 than pretreatment in the research and than the control group（P〈0.01）, there were no significant differences between pretreatment and at the ends of week 4 and 6 in the research as well as in synchronization comparison between the research and control group（P〉0.05）. Conclusion Clozapine plus fluoxetine could significantly improve depressive symptoms, meanwhile has joint action in improving psychiatric symptoms, and does＇nt aggravate clozapine adverse reactions and affect treatment compliance.
出处
《临床心身疾病杂志》
CAS
2008年第3期211-213,共3页
Journal of Clinical Psychosomatic Diseases
关键词
精神分裂症
抑郁
氟西汀
氯氮平
Schizophrenia
depression
fluoxetine
clozapine
