西酞普兰与米安色林治疗老年抑郁症的对照研究

目的比较西酞普兰与米安色林治疗老年抑郁症的疗效和不良反应。方法将60例老年抑郁症患者随机分为西酞普兰组和米安色林组。分别给予西酞普兰和米安色林治疗,疗程8周,采用汉密尔顿抑郁量表（HAMD）及不良反应量表（TESS）评定疗效和不良反应。结果西酞普兰组和米安色林组显效率分别为83.3%和80.0%,二者疗效相当。HAMD评分西酞普兰组第2周末显著下降,而米安色林组治疗第1周末即显著下降,不良反应方面,西酞普兰组以口干、恶心、出汗增多、头昏、睡眠时间缩短为主,米安色林组则以嗜睡、口干、便秘为主。结论西酞普兰和米安色林均为治疗老年抑郁症的安全有效的药物。     

草酸艾司西酞普兰治疗抑郁症临床观察

目的观察草酸艾司西酞普兰治疗抑郁症的效果。方法将来本院精神科门诊及病房治疗的54例抑郁症患者随机分为观察组和对照组,每组27例。观察组患者给予草酸艾司西酞普兰治疗,对照组患者给予氟西汀,于治疗后1周、2周、4周、6周分别观察两组患者汉密尔顿抑郁量表(HAMD)评分,并进行比较;同时观察不良反应发生情况;治疗结束后评价治疗效果。结果自身比较:治疗后两组各时间点HAMD评分均低于治疗前,随治疗时间的延长HAMD评分呈逐渐降低趋势。组间比较:治疗前两组HAMD评分差别不大,差异无统计学意义;治疗后1、2周时观察组HAMD评分均高于对照组,差异有统计学意义。观察组总有效率高于对照组,不良反应发生率低于对照组,差异均有统计学意义。结论草酸艾司西酞普兰治疗抑郁症具有较好的临床疗效,且不良反应少。     

草酸艾司西酞普兰与盐酸舍曲林治疗抑郁症的临床对照研究

目的了解草酸艾司西酞普兰治疗抑郁症的疗效及安全性。方法对106例符合ICD-10中抑郁症诊断标准的患者。随机分成2组,分别给予草酸艾司西酞普兰与盐酸舍曲林进行为期8周的治疗。采用17项汉密尔顿抑郁表(HAMD)评价疾病的严重程度及评定临床疗效。不良反应量表(TESS)评估药物的不良反应。结果治疗后草酸艾司西酞普兰组与盐酸舍曲林组在汉密尔顿抑郁量表(HAMD)减分率无明显差异。草酸艾司西酞普兰组有效率为88.7%,盐酸舍曲林组效率为90.6%,2组疗效比较差异无统计学意义(P>0.05)。不良反应量表(TESS):草酸艾司西酞普兰组不良反应少。结论草酸艾司西酞普兰能有效控制抑郁症状,不良反应少,对抑郁症患者是一种较为理想的抗抑郁药物。     

草酸艾司西酞普兰治疗老年冠心病并发抑郁症的临床疗效

目的观察草酸艾司西酞普兰治疗老年冠心病并发抑郁症患者的疗效。方法选择冠心病伴发抑郁障碍患者54例,随机分为治疗组（30例）与对照组（24例）。治疗组给予草酸艾司西酞普兰治疗和心理干预,起始日剂量10mg,最高日剂量为20mg,并行积极心理干预,总疗程为6周;对照组采用常规药物治疗。治疗1、2、4、6周后评定疗效,同时观察不良反应。结果治疗组患者治疗1、2、4、6周后SAS、SDS、HAMD评分、抑郁情绪改善程度和血清同型半胱氨酸、超敏c反应蛋白下降程度、临床总有效率均优于对照组（P〈0．01或P〈0．05）。结论草酸艾司西酞普兰治疗加上心理干预对冠心病抑郁症患者疗效好,且起效快（1周）,依从性好,不良反应少,安全性高。     

草酸艾司西酞普兰联合奥氮平治疗老年抑郁症的临床研究

目的探讨草酸艾司西酞普兰联合奥氮平对老年抑郁症的治疗效果。方法选择80例从2015年8月至2017年8月在我院接受救治的老年抑郁症患者进行研究,分组依据为两组患者所用治疗方式。对照组服用奥氮平,观察组在对照组基础上加用草酸艾司西酞普兰,对入组患者治疗效果予以对比。结果观察组治疗有效率95.0%(38/40)明显高于对照组有效率77.5%(31/40)(P<0.05);对照组治疗前SAS评分和SDS评分依次为(70.8±1.6)分和(71.2±0.9)分,相比于观察组,差异无统计学意义(P>0.05),对两组患者治疗后心理状态进行比较,差异有统计学意义(P<0.05)。结论给予老年抑郁症患者草酸艾司西酞普兰联合奥氮平治疗方案,既可提高治疗效果,又能减轻患者负面情绪,推广应用价值明显。     

草酸艾司西酞普兰与盐酸度洛西汀治疗抑郁症的效果对照分析

目的:观察分析草酸艾司西酞普兰与盐酸度洛西汀治疗抑郁症的效果对照.方法:选择我院2015年2月~2016年2月治疗的82例抑郁症患者作为研究对象,随机分成两组,研究组和对照组均41例,对照组采取草酸艾司西酞普兰治疗,研究组采取盐酸度洛西汀治疗,对两组疗效及不良反应进行分析比较.结果:治疗前,两组HAMD评分与HAMA评分比较,差异没有统计学意义(P>0.05),治疗后,两组HAMD评分与HAMA评分比较,差异没有统计学意义(P>0.05);研究组不良反应发生率与对照组比较,差异没有统计学意义(P>0.05).结论:采取草酸艾司西酞普兰与盐酸度洛西汀治疗抑郁症均有较好的疗效,值得在临床上推广.     

草酸艾司西酞普兰对抑郁症的治疗效果分析

目的 探析草酸艾司西酞普兰治疗抑郁症患者的临床效果.方法 82例抑郁症患者,依据均衡原则分为对照组与观察组,各41例.对照组予以盐酸氟西汀治疗,观察组予以草酸艾司西酞普兰治疗.比较两组患者临床疗效、汉密尔顿抑郁量表(HAMD)评分、临床疗效总评量表(CGI)评分及不良反应发生情况.结果 观察组患者治疗总有效率为75.6...     

草酸艾司西酞普兰联合小剂量奥氮平治疗老年期抑郁症的效果观察

目的：观察草酸艾司西酞普兰联合小剂量奥氮平治疗老年期抑郁症的临床疗效。方法选取2013年6月-2014年7月老年科收治的住院或门诊患者60例,随机分为试验组和对照组各30例。试验组予草酸艾司西酞普兰合并奥氮平治疗,对照组仅予草酸艾司西酞普兰治疗,治疗共进行8周,采用汉密顿抑郁量表（HAMD）,不良反应量表（TESS）进行测评。结果试验组显效率83.00%明显高于对照组的73.00%,差异有统计学意义（P ＜0.05）;2组治疗后 HAMD 评分比较差异有统计学意义（P ＜0.05）。试验组嗜睡、体质量增加不良反应发生人数较对照组高,比较差异有统计学意义（P ＜0.05）;而2组口干、恶心、心动过速等不良反应比较差异无统计学意义（P ＞0.05）。结论老年抑郁症患者可以考虑草酸艾司西酞普兰合并小剂量奥氮平治疗,疗效显著。值得临床推广运用。     

草酸艾司西酞普兰联合小剂量氨磺必利治疗老年抑郁症的对照研究

目的探讨草酸艾司西酞普兰联合小剂量氨磺必利治疗老年抑郁症的临床疗效和安全性。方法将62例老年抑郁症患者分为研究组和对照组。研究组使用草酸艾司西酞普兰联合小剂量氨磺必利治疗,对照组单用草酸艾司西酞普兰治疗。观察6周,于治疗前及治疗后第1周、第2周、第4周、第6周末采用汉密尔顿抑郁量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组汉密尔顿抑郁量表评分较治疗前显著下降(P<0.05或P<0.01),同期研究组均较对照组下降更显著(P<0.01);治疗6周末研究组显效率及总有效率均高于对照组,但差异无显著性(P>0.05);两组不良反应较轻微,发生率差异无显著性(P>0.05)。结论草酸艾司西酞普兰联合小剂量氨磺必利治疗老年抑郁症疗效显著,起效快,安全性高,依从性好,值得临床摧广应用。     

草酸艾司西酞普兰与盐酸帕罗西汀治疗抑郁症的疗效评价

目的观察草酸艾司西酞普兰与盐酸帕罗西汀治疗抑郁症的疗效及不良反应。方法将60例抑郁症患者随机分为研究组和对照组各30例。研究组予以草酸艾司西酞普兰治疗,对照组予以盐酸帕罗西汀治疗,疗程均为8周。采用汉密尔顿抑郁量表（HAMD）评定临床疗效,不良反应量表（TESS）评定不良反应和安全性。结果研究组与对照组临床疗效相当,2组比较差异无统计学意义（P〉0.05）。草酸艾司西酞普兰显效更快,不良反应更少。结论草酸艾司西酞普兰治疗抑郁症疗效与盐酸帕罗西汀相当,且不良反应更少,患者依从性更好,适于长期维持治疗。     

艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的对照研究

目的探讨艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的临床疗效及安全性。方法将68例患者随机分为A组和B组,各34例,A组口服草酸艾司西酞普兰,B组口服帕罗西汀。两组于治疗前和治疗后1,2,4,8周末采用汉密尔顿抑郁量表(HAMD)评定疗效,不良反应量表(TESS)评定不良反应。结果两组治疗后HAMD评分均较治疗前显著下降,差异有统计学意义(P<0.01);A组和B组疗效总有效率分别为94.12%和91.18%,不良反应率分别为35.29%和38.24%,差异均无统计学意义(P>0.05)。结论艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的疗效相当,但艾司西酞普兰起效更快,不良反应更轻,适合作为老年脑卒中后抑郁患者的一线用药。     

米安色林与丙咪嗪治疗抑郁症的临床对照研究

目的 评价米安色林与丙咪嗪治疗抑郁症的临床疗效和安全性。方法 将51例符合CCMD-3抑郁症诊断标准的抑郁症患者随机分为两组，分别给予米安色林和丙咪嗪治疗，于治疗前和治疗后1，2，4，6周末分别采用汉密尔顿抑郁量表（HAMD量表）、临床疗效总体评定量表及不良反应量表评定。结果 米安色林与丙咪嗪总体疗效相似（P〉0．05）；米安色林组治疗第1周就起效；治疗前与治疗后比较，HAMD评分两组均有显著性差异（P〈0．01），两组之间则无显著性差异（P〉0．05），米安色林组的不良反应少于丙咪嗪组。结论米安色林是一种安全有效的新一代抗抑郁药物，适用于伴有失眠症状的老年抑郁症患者。     

艾司西酞普兰与西酞普兰治疗抑郁症的对照研究

目的评价艾司西酞普兰治疗抑郁症的有效性和安全性。方法选择126例抑郁症患者,试验组63例,口服艾司西酞普兰:1-2周口服10 mg,3-6周剂量可调10-20 mg;对照组63例,口服西酞普兰:1-2周口服20 mg,3-6周剂量可调20-40 mg。疗程6周,以十七项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)和临床总体印象量表(CGI)进行疗效评价;以不良事件、实验室检查和心电图检查等评价安全性。结果共106例患者完成研究,试验组52例,对照组54例。试验组与对照组6周末有效率(82.7%vs 88.9%,P=0.484)、痊愈率(36.5%vs.27.8%,P=0.360),2组差异无统计学意义(P>0.05)。HAMA和CGI的评分在各时间点2组相比差异无统计学意义(P>0.05)。试验组与对照组不良反应发生率(17.5%vs 30.2%,P=0.07)差异无统计学意义。结论艾司西酞普兰治疗抑郁症安全有效,与西酞普兰相当,不良反应较轻。     

Escitalopram

Escitalopram oxalate (S-citalopram, Lexapro^?), a selective serotonin re-uptake inhibitor antidepressant which is the S-enantiomer of citalopram, is in clinical development worldwide for the treatment of depression and anxiety disorders. Preclinical studies demonstrate that the therapeutic activity of citalopram resides in the S-isomer and that escitalopram binds with high affinity to the human serotonin transporter. Conversely, R-citalopram is ～ 30-fold less potent than escitalopram at this transporter. Escitalopram has linear pharmacokinetics, so that plasma levels increase proportionately and predictably with increased doses and its half-life of 27 – 32 h is consistent with once-daily dosing. In addition, escitalopram has negligible effects on cytochrome P450 drug-metabolising enzymes in vitro, suggesting a low potential for drug–drug interactions. The efficacy of escitalopram in patients with major depressive disorder has been demonstrated in multiple short-term, placebo-controlled clinical trials, three of which included citalopram as an active control, as well as in a 36-week study evaluating efficacy in the prevention of depression relapse. In these studies, escitalopram was shown to have robust efficacy in the treatment of depression and associated symptoms of anxiety relative to placebo. Efficacy has also been shown in treating generalised anxiety disorder, panic disorder and social anxiety disorder. Results also suggest that, at comparable doses, escitalopram demonstrates clinically relevant and statistically significant superiority to placebo treatment earlier than citalopram. Analysis of the safety database shows a low rate of discontinuation due to adverse events, and there was no statistically significant difference between escitalopram 10 mg/day and placebo in the proportion of patients who discontinued treatment early because of adverse events. The most common adverse events associated with escitalopram which occurred at a rate greater than placebo include nausea, insomnia, ejaculation disorder, diarrhoea, dry mouth and somnolence. Only nausea occurred in > 10% of escitalopram-treated patients.     

Double-Blind Randomized Controlled Pilot Study of the Efficacy and Tolerability of Pirlindole,a Reversible Inhibitor of Monoamine Oxidase A,and Mianserin,in the Treatment of Depression

This double-blind randomized pilot study aimed to compare the efficacy and the tolerability of pirlindole (150–225 mg/day), a reversible inhibitor of monoamine oxidase A, and mianserin (60–90 mg/day) in the treatment of major depression. Forty patients were included in the trial (20 pirlindole and 20 mianserin) and 38 patients (18 pirlindole and 20 mianserin) completed the whole study (28 days of administration). Both treatments exhibited highly significant improvements in the Hamilton Depression Rating Scale score (HDRS), the Hamilton Anxiety Rating Scale score (HARS) and the Beck auto-evaluation scale score (BECK) from day 7 up to day 28. The evolution of the HDRS score in the two groups did not differ significantly. The evolution of the HARS and BECK scores taken separately and the evolution of the combined total score (HDRS + HARS + BECK) significantly differed between the two groups, pirlindole producing a significantly higher decrease than mianserin in the two separate scores on day 28 and on days 21 and 28 in the case of the combined total score. Two patients experienced adverse reactions, one in the pirlindole group complained of sleep disturbances and one in the mianserin group suffered from dry mouth. The results of this study attest to the efficacy and tolerability of pirlindole in the treatment of depression. © 1997 John Wiley & Sons, Ltd.     

Thyroxine Augmentation of Fluoxetine Treatment for Resistant Depression in the Elderly: An Open Trial

Drug resistant depression is a confounding entity. More so in populations of elderly depressives where addition of lithium or antidepressant combinations are possibly hazardous. We present an open-trial of thyroxine in elderly patients diagnosed as suffering from resistant depression. Methods—Thyroxine 50 mcg/day was added to fluoxetine 20 mg/day in patients who did not respond to previous, non-SSRI, antidepressant treatment (6 weeks), nor to an additional 6 weeks of fluoxetine. Subjects—Subjects were diagnosed as suffering from major depression, according to DSM-III-R criteria. All had normal thyroid function tests (TSH and FT₄). There were 15 patients in our series: nine females, six males; mean age 72·1 years (±6·5). Results—Patients depression severity was graded using the Hamilton Depression Rating Scale at baseline (before thyroxine augmentation), and 4 weeks after initiation of treatment. Ten of 15 patients responded to thyroxine augmentation (HDRS<10), 3/15 showed no improvement of HDRS scores and two dropped out due to adverse effects: diarrhoea and tachycardia. Conclusions—Thyroxine augmentation of fluoxetine is effective in elderly subjects resistant to standard treatment, and is relatively safe.     

米安舍林治疗精神分裂症后抑郁症43例

目的比较米安舍林与阿米替林治疗精神分裂症后抑郁症的疗效与安全性。方法86例精神分裂症后抑郁患者随机分为治疗组和对照组各43例，治疗组给予米安舍林30～90 mg·d^-1，对照组给予阿米替林75～225 mg·d^-1，进行为期6周的随机对照试验，用汉密顿抑郁量表（HAMD）、阳性与阴性症状量表（PANSS）评定临床疗效，用不良反应量表（TESS）评定不良反应。结果米安舍林和阿米替林治疗精神分裂症后抑郁疗效相当（P＞0.05），其显效率分别为62.8%和65.1%，两组治疗前后HAMD、PANSS评分分别比较，均有极显著性改善（P＜0.01），但米安舍林起效快，且不良反应少而轻。结论米安舍林治疗精神分裂症后抑郁疗效肯定，用药安全，耐受性好。     

Controlled Comparison of Tianeptine,Alprazolam and Mianserin in the Treatment of Adjustment Disorders with Anxiety and Depression

A multicentre study compared tianeptine (37·5 mg/day), an original psychotropic compound characterized by both antidepressant and anxiolytic potentials, with a reference antidepressant, mianserin (60 mg/day) and a reference anxiolytic, alprazolam (1·5 mg/day), in the treatment of 152 patients fulfilling DSM-III-R criteria for adjustment disorder with mixed emotional features (anxiety and depression). The study used a double-blind parallel design over a 6-week period. Clinical assessments included the Clinical Global Impressions (CGI), the Montgomery and Asberg depression rating scale (MADRS), the Hamilton anxiety rating scale, a visual analogue scale, and the somatic scale of the system developed by the Association for the Methodology and Documentation in Psychiatry (AMDP). Results showed very similar improvement in the three treatment groups on all rating instruments. Moreover, the number of patients exhibiting adverse events did not differ among the three groups. Therefore, these results show similar antidepressant and anxiolytic activity for tianeptine, mianserin and alprazolam in patients suffering from adjustment disorder with mixed emotional features. These promising findings should however be confirmed in a placebo-controlled trial.     

西酞普兰与米安舍林治疗老年抑郁症的对照研究

目的比较西酞普兰与米安舍林治疗老年抑郁症的疗效及安全性。方法选择符合入组条件的78例抑郁症患者,随机分为两组,分别给予西酞普兰与米安舍林治疗,疗程8周,采用汉密尔顿抑郁量表（HAMD）及汉密尔顿焦虑量表（HAMA）在治疗前及治疗的2、4、6、8周评定药物疗效;用副反应量表（TESS）评定不良反应。结果西酞普兰组与米安舍林组总体疗效相当,疗后HAMD和HAMA总分均有显著减少,西酞普兰组起效快,不良反应轻,安全性好。结论西酞普兰治疗老年抑郁症安全有效,并且起效快。不良反应轻。