摘要
目的观察米氮平对更年期首发抑郁障碍患者的疗效和不良反应。方法将符合入组标准的90例患者随机分成米氮平组45例,帕罗西汀组45例。于治疗前和第1、4、8周末采用汉密尔顿抑郁量表(HAMD)17项及汉密尔顿焦虑量表(HAMA)评定疾病严重程度和疗效;采用不良反应量表(TESS)评定药物不良反应。结果米氮平组痊愈28例,好转12例,有效率88.9%;帕罗西汀组痊愈23例,好转14例,有效率82.2%;两组差异无显著性。米氮平组治疗第1周末的HAMD-17和HAMA总分及第8周末的HAMD-17总分明显低于帕罗西汀组(21.3±3.5/25.2±2.9,18.2±3.2/21.5±2.4,t=-2.367、-3.514,P=0.042、0.032;7.2±3.5/9.8±2.3,t=-3.258,P=0.035)。米氮平组药物不良反应主要是食欲增加7例,体重增加6例,水肿4例,口干3例,睡眠障碍2例,恶心2例;帕罗西汀组不良反应主要是口干10例,睡眠障碍9例,恶心8例,震颤或坐立不安7例,烦躁或激越6例,性功能障碍5例。食欲增加和睡眠障碍的发生率两组之间差异有显著性(确切P值=0.012、0.050)。结论米氮平治疗女性更年期首发抑郁障碍起效时间较快,抗抑郁作用较强,不良反应较少。
Objective： To study the efficacy and safety of mirtazapine and paroxetine in patients with first-episode climacteric depression. Methods： A 8-week double-blind study was conducted with 90 female patients suffered with climacteric first-episode depression. Subjects were randomly assigned to either mirtazapine （ n = 45 ） or paroxetine in =45） . All subjects were evaluated with Hamilton Rating Scale for Depression-17 （HAMD - 17）, Hamilton Rating Scale for Anxiety, and Treatment Emergent Symptom scale （ TESS ） at baseline, the end of week 1,4 and 8 after treatment. The study had lasted for 8 weeks. Results： The response rate between two groups （ mirtazapine 88.9% vs paroxetine 82. 2% ） was similar. There were significant differences on the scores of HAMD between the two groups at the end of 1st and 8th week, and HAMA at the 1st week after treatment （21.3 ±3.5/25.2 ±2. 9, 18. 2 ±3. 2/21.5 ±2.4, t=-2.367, -3.514, P=0.042, 0.032; 7.2±3.5/9.8±2.3, t=-3.258, P=0.035） . Mirtazapine had increased food appetite （ 15.6% ）, body weight （ 13.3% ）, hydropsia （8.9%）, dry mouth （6. 7% ）, sleep disorder and nausea （4.4% ） . Meanwhile paroxetine had dry mouth （22. 2% ）, sleep disorder （20. 0% ）, nausea （ 17.8% ）, tremor （ 15.6% ）, restlessness/agitation （ 13.3% ） and sexual disturbance （ 11.1% ） . Conclusion： Mirtazapine has rapid response, strongly antidepressive effect in female climacteric first-episode patients and less sideeffects.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2007年第6期428-430,共3页
Chinese Mental Health Journal
关键词
米氮乎
帕罗西汀
更年期
首发抑郁障碍
双盲研究
Mirtazapine
paroxetine
first-episode depression
female climacteric
double-blind study
