选择性5-羟色胺再摄取抑制剂联合丙戊酸钠缓释剂治疗伴激越、焦虑抑郁症的临床观察

目的: 观察选择性5-羟色胺再摄取抑制剂(SSRI)联合应用丙戊酸钠缓释剂治疗伴有激越、焦虑症状抑郁症的疗效及安全性。方法: 80例符合抑郁症诊断标准同时伴有激越症状、焦虑症状患者随机分为研究组(在SSRI的基础上联合丙戊酸钠缓释剂)和对照组(仅仅使用SSRI),每组40例。分别于治疗前、治疗后1、2、4、8周使用汉密尔顿抑郁评定量表(HAMD)、汉密尔顿焦虑评定量表(HAMA)、杨氏躁狂量表(YMRS)、副反应量表(TESS)评价疗效和不良反应。结果: 研究组有2例失访脱落,治疗后1、2、4、8周的有效率和痊愈率分别是 28.9%(11/38)与 7.9%(3/38)、36.8%(14/38)与 13.2%(5/38)、50%(19/38)与 28.9%(11/38)、89.5%(34/38)与 52.6%(20/38)。对照组因副作用3例脱落、其中1例因转躁退出,治疗后1、2、4、8周的有效率和痊愈率分别是 21.6%(8/37)与 5.4%(2/37)、32.4%(12/37)与 8.1%(3/37)、43.2%(16/37)与 18.9%(7/37)、54.1%(20/37)与 32.4%(12/37)。两组治疗后1、2、4、8周末HAMD、HAMA、YMRS评分,与治疗前相比均有统计学差异(P<0.01)。对照组从治疗后第1周到第8周,各时点的3个量表评分均高于研究组,差异有统计学意义( P<0.05 或 0.01)。不良反应总体发生数两组间比较无统计学差异(P>0.05)。结论: 丙戊酸钠缓释剂联合SSRI治疗某些伴有激越、焦虑症状的抑郁症疗效优于单一使用SSRI,且安全性较高。

Comparing study on therapeutic of outpatients with agitated or anxiety depression by combination of SSRI and sodium valproate RX

AIM: To observe the efficacy and safety of selective serotonin reuptake inhibitors (SSRI) collaborating with Sodium Valproate RX on the treatment of depression with agitation or anxiety. METHODS: Totally 80 cases which conform to the diagnostic criteria of depression with agitation or anxiety were randomly divided into the treatment group (using SSRI collaborating with Sodium Valproate RX) and the control group (only using SSRI), each group had 40 cases. The efficacy and safety were assessed by Hamilton Depression Rating Scale (HAMD), Hamilton anxiety rating scale (HAMA), Young Mania Rating Scale (YMRS) and Treatment Emergent Side-Effect Scale (TESS) at pretreated, 1-week, 2-week, 4-week and 8-week after treatment. RESULTS: 2 cases dropout for lost in 40 cases of the treatment group. The effective rate and full remission rate were 28.9%(11/38)and 7.9%(3/38),36.8%(14/38)and 13.2%(5/38),50%(19/38)and 28.9%(11/38),89.5%(34/38)and 52.6%(20/38) at 1-week, 2-week, 4-week and 8-week after treatment in treatment group . Meanwhile 3 cases dropout in 40 cases of the control group for side reactions (1 for swiching to mania ). The effective rate and full remission rate were 21.6%(8/37)and 5.4%(2/37),32.4%(12/37)and 8.1%(3/37),43.2%(16/37)and 18.9%(7/37),54.1%(20/37)and 32.4%(12/37)at 1-week, 2-week, 4-week and 8-week after treatment in control group. Compared with before treatment, the levels of HAMD,HAMA,YMRS had significant difference at 1-week, 2-week, 4-week and 8-week after treatment in two groups (P<0.01).There was no significant difference of the overall number of adverse reaction between the two groups (P>0.05). CONCLUSION: The combination of SSRI and Sodium Valproate RX maybe one of better ways in the treatment of depression.with agitation or anxiety for their better efficacy and higher safety than the sole using of SSRI.