帕罗西汀对癫伴发抑郁患者的疗效分析

Clinical efficacy and safety of paroxeline in patients with epilepsy and concomitant depression

目的 探讨帕罗西汀对癫(癎)伴发抑郁患者临床治疗的有效性及安全性.方法 21例门诊与住院的癫(癎)伴发抑郁患者,入组前汉密顿抑郁量表(HAMD)24项评分≥18分,持续予帕罗西汀10～20mg·d-1晨服,治疗观察期均为8周,于入组后第4、8周分别用HAMD及Zung抑郁自评量表(SDS)评分,AEDs用药保持不变.结果 帕罗西汀治疗第8周后,HAMD量表评分由治疗前(25.33±4.89)降至(12.10± 6.12),SDS量表评分由治疗前(45.90±6.82)降至(28.95±6.98),差异均有统计学意义.不良事件发生率也基本上很轻微、短暂.治疗过程中,癫(癎)每月发作次数由治疗前的(1.43±0.92)到治疗后第8周的(1.57±0.98)(P＞0.05),差异无统计学意义.没有新发全身强直-阵挛发作的患者.结论 帕罗西汀对癫(癎)伴抑郁患者的治疗有效、安全.

Objective To investigate the clinical efficacy and safety of paroxeline in patients with epilepsy and concomitant depression. Methods All 21 out-patients and hospitalization patients with epilepsy and concomitant depression,which were no smaller than 18 on the 24 items of the Hamilton Scale for Depression(HAMD) before treatment,were kept on taking paroxeline 10～20 mg/d.The treatment and observation duration were 8 weeks.Depression was rated using HAMD and Zung depression rating scales(SDS).Clinical assessments were performed before,in 4th and 8th week of paroxeline therapy.Depressed epileptic patients were kept constant with on antiepileptic drugs(AEDs).Results We observed a decrease in the total score on the HAMD from a mean initial value of(25.33±4.89) prior to(12.10±6.12)(P<0.01) after 8 weeks of treatment and the total score on the SDS from a mean initial value of(45.90 ±6.82) prior to(28.95±6.98)(P<0.01) after 8 weeks of treatment.No seizure worsening was observed in patients.Monthly seizure frequency did not change significantly(P>0.05) from(1.43 ± 0.92) seizures before treatment with paroxeline to(1.57± 0.98) seizures in the 8th week of treatment.No occurrence of generalized tonic-clonic seizures was recorded in individual patients. Conclusion Paroxeline is a safe and effective antidepressant in the treatment of patients with epilepsy and concomitant depression.