摘要
目的观察心境稳定剂对单次发作抑郁症预防转躁的效果,同时观察联合用药对疗效和副反应的影响。方法对106例单次发作抑郁症患者随机分为文拉法辛缓释剂联合丙戊酸镁组和单用文拉法辛缓释剂组,在基线、2、4、8、12、和24周分别给予倍克-拉范森躁狂量表(BRMS),汉密尔顿抑郁量表(17项)(HAMD17),蒙哥马利抑郁量表(MADRS),临床疗效总评量表-疾病严重度(CGI-S)评定,不良反应用不良反应量表(TESS)评定。结果52例患者接受文拉法辛缓释剂联合丙戊酸镁治疗,54例患者单用文拉法辛缓释剂治疗,至24周治疗随访结束时,联合治疗组1例患者转躁,单药治疗组8例转躁,具有显著性差异。而两组24周末的临床治愈和有效率分别54%、77%和50%、70%,无显著差异。各时点的HAMD17、MADRS、CGI-S评分无差异。不良反应除食欲下降、恶心、呕吐、嗜睡和乏力联合治疗组多于单药治疗组外,其余均无显著差异。结论单次发作抑郁症患者在使用文拉法辛联合丙戊酸镁治疗时可减少躁狂发生率,抗抑郁疗效与单用文拉法辛相似。联合用药时部分不良反应虽有所增加,但耐受性与单药治疗无差异。
Objective To evaluate the efficacy of mood stabilizer for prevention of switch to mania in the first episode of depression. Methods One hundred and six inpatients diagnosed first episode of depression were randomly assigned to venlafaxine XR with Mg Valproate treatment group （combined treatment group） and venlafaxine XR treatment alone group （mono treatment group）. The patients were assessed with Bech-Rafaelson Mania Scale （BRMS）, Hamilton Rating Scale for Depression-17 items （HAMD17）, Montgomery-Asberg Depression Rating Scale （MADRS）, Clinical Global Impression for Severity （CGI-S） and Treatment Emergent Symptom Scale （TESS） at baseline, week2, 4, 8, 12 and 24 after treatment. Results Fifty two patients received the combined treatment while fifty four patients treated with mono treatment. At the end of 24 weeks treatment, one patient in combined group and eight patients in mono treatment group experienced manic episode, there was a significant difference between two groups. The remission rate and response rate did not reach a significant difference between two groups as 54% and 77% in the combined treatment group and 50% and 70% in the mono treatment group respectively. Some side effects such as decrease of appetite nausea, vomiting, somnolence, fatigue were more frequently seen in the combined group than in the mono treatment group. Conclusion Mood stabilizer combined antidepressant in the use of first episode depression can reduce the probability of switch to manic episode, though some adverse reactions are more frequent in the combined treatment, the tolerability is similar between combined treatment and antidepressant alone treatment.
出处
《浙江医学》
CAS
2008年第12期1310-1312,共3页
Zhejiang Medical Journal
基金
湖州市科技局科研项目(2005YS10)
