文拉法辛联合利培酮治疗精神病性抑郁症对照研究

目的研究文拉法辛联合利培酮治疗精神病性抑郁症的临床疗效及安全性。方法将80例精神病性抑郁症患者随机分为两组各40例，两组均口服利培酮治疗，研究组联合文拉法辛治疗，对照组联合阿米替林治疗，观察6w。于治疗前及治疗第1w、2w、4w、6w末采用汉密顿抑郁量表、简明精神病量表、临床疗效总评量表、副反应量表评定临床疗效及不良反应。结果治疗6w末抑郁症状研究组显效率为78％，对照组为75％；精神病性症状研究组显效率为80％，对照组为83％，两组总体疗效相当（P〉0.05）。汉密顿抑郁量表、简明精神病量表总分及临床疗效总评量表评分两组治疗1w末起均较治疗前有显著下降（P〈0.01）；但研究组治疗2w末汉密顿抑郁量表评分及4w末简明精神病量表、临床疗效总评量表评分均较对照组下降显著（P〈0.05）。副反应量表评分研究组治疗1w、2w、4w、6w末均显著低于对照组（P目〈0.01），研究组静坐不能、嗜睡、心电图改变、震颤不良反应发生率均显著低于对照组（P〈0.01～0.05）。结论两组总体临床疗效相当，但研究组起效更快、安全性更高、依从性更好。

Venlafaxine plus risperidone in the treatment of psychotic depression

Objective To study the clinical efficacy and safety of venlafaxine combined with risperidone in the treatment of psychotic depression.Methods 80 patients with psychotic depression were randomly divided into research group(n=40)taking orally risperidone combined with velafaxine and control group(n=40)risperidone with amitriptyline for 6 weeks.Clinical efficacy was assessed with the Hamilton Depression Scale(HAMD),the Brief Psychiatric Rating Scale(BPRS)and Clinical Global Impression(CGI)and adverse effect with the Treatment Emergent Symptom Scale(TESS)before treatment and at the end of the 1st,2nd,4th and 6th week treatment.Results At the end of the 6th week,excellence rates were respectively 78% in the research group and 75% in the control;excellence rates of psychotic symptoms were 80% in the research and 83% in the control respectively,total efficacies of the 2 groups equivalent(P>0.05).Since the end of the 1st week,total scores of the HAMD,BPRS and CGI lowered significantly compared with pretreatment for both groups(P<0.01);the HAMD score at the end of the 2nd week and the BPRS and CGI scores at the end of the 4th week lowered more significantly in the research than in the control(P<0.05).All timepoint TESS scores(all P<0.01)and incidences of such adverse effects as akathisia,drowsiness,ECG changes and tremor(P<0.01~0.05)were significantly lower in the research than in the control.Conclusion The two groups have equivalent clinical efficacy,and the research groups takes effects faster and has higher safety and better compliance.