摘要
目的 探讨艾司西酞普兰与氟西汀治疗精神分裂症后抑郁的疗效和安全性以及对认知功能的影响.方法 将60例精神分裂症后抑郁患者随机分为两组,每组30例,在维持原用抗精神病药物治疗的基础上,研究组晨口服艾司西酞普兰治疗,对照组晨口服氟西汀治疗,观察8周.于治疗前及治疗1周、2周、4周、6周、8周末采用汉密顿抑郁量表评定抑郁症状,临床疗效总评量表-病情严重程度分量表评定治疗效果,副反应量表评定不良反应;于治疗前及治疗8周末采用词汇流畅测验和威斯康星卡片分类测验评定认知功能.结果 治疗后两组汉密顿抑郁量表及临床疗效总评量表-病情严重程度分量表评分减分值随着治疗时间的延续均呈持续性升高;研究组治疗第1周末汉密顿抑郁量表及临床疗效总评量表-病情严重程度分量表减分值及总有效率均显著高于对照组（P＜0.05或0.01）,治疗8周末研究组总有效率为76.7%,对照组为70.0%,两组差异无显著性（χ2=0.09,P＞0.05）;治疗后两组词汇流畅性测验评分均显著高于治疗前（t=5.88、6.00,P＜0.01）,威斯康星卡片分类测验总测验数、持续错误数及随机错误数均较治疗前显著下降（P＜0.05或0.01）;两组不良反应程度均较轻微,发生率差异无显著性（χ2=0.07,P＞0.05）.结论艾司西酞普兰治疗精神分裂症后抑郁疗效与氟西汀相当,能显著改善认知功能,安全性高,依从性好,但艾司西酞普兰起效更快,可作为治疗精神分裂症后抑郁的一线药物.
Objective To explore the efficacy and safety of escitalopram vs. fluoxetine in post-schizophrenic depression （PSD） and their effects on cognitive function. Methods Sixty PSD patients were randomly divided into two groups of 30 one each, based on previous antipsychotic treatment research group took o- rally escitalopram in the morning and control group did fluoxetine for 8 weeks. Before treatment and at the end of the 1st , 2nd , 4th , 6th and 8th week depressive symptoms were assessed with the Hamilton Depression Scale （HAMD）, effieacies with the Clinical Global Impression-Severity of Illness （CGI-SI） and adverse reactions with the Treatment Emergent Symptom Scale （TESS）; before treatment and at the end of the 8th week cognitive function was assessed with the Verbal Fluency Test （VFT） and the Wisconsin Card Sorting Test （WCST）. Results The decreased score of the CGI-SI of both groups heightened continiouely with treatment; at the end of the 1st week, the decreased scores of both the HAMD and and total effective rates were significantly higher in the research than in the control group （P〈0.05 or 0.01） ; at the end of the 8th week, total effective rates had no significant differences （76.7% vs. 70.0%, ）C2 =0.09,P〉0.05） ; the VFT scores of both groups were significantly higher （t=5.88, 6.00,P〈0.01） and total, persistent error and random error number of the WCST significantly lowered （P〈0.05 or 0.01） after treatment compared with pretreatment; adverse reactions of both groups were mild, thier incidences had no significant differences （x2 =0.07, P〉0.05）. Conclusion Escitalopram has efficacy equivalent to fluoxetine in post-schizophrenic depression, can improve cognitive function, has higher safety and better compliance, but escitalopram takes effect more rapidly and can be used as the first-line drug.
出处
《临床心身疾病杂志》
CAS
2011年第4期304-306,共3页
Journal of Clinical Psychosomatic Diseases
