氟西汀对脑卒中后强哭、强笑的治疗作用

Efficacy of Fluoxatine in Treatment of Pathological Crying and Laughing after Stroke

目的 观察氟西汀 (商品名百优解 )对脑卒中后强哭、强笑的治疗效果。方法 随机选择脑卒中后强哭病例 1 7例和强哭伴强笑 1 4例 ,给予百优解 2 0 mg/d,早饭后 1次服用 ,观察 4周。治疗前后记录每天的发作次数并行汉密尔顿抑郁量表评分。结果 百优解对于强哭和强笑均有良好疗效 ,其疗效与抑郁状态的改善无关 ,对强哭的疗效比对强笑的疗效似乎更好。结论 中枢 5 -羟色胺递质系统在强哭、强笑的发生过程中起重要作用 ,但强哭、强笑的发生是否有完全一样的解剖基础和发病机制 ,还需进一步研究。

Objective To estimate the effectiveness of fluoxatine treatment in patients with pathological crying and pathological laughing after brain stroke. Methods Seventeen pathological crying patients and 14 pathological crying with pathological laughing patients were included and was treated with fluoxatine (20 mg/d) for 4 weeks in this study. Results Fluoxatine is effective in the treatment of both pathological crying and laughing,but the efficacy in pathological crying is better than that in pathological laughing patients. Although HAMD scale(17 items) in most of these patients was higher than 17 scores,the improvement in emotional lability was independent on depression status. Conclusions 5-serotonine system might play an important role in pathological crying and laughing after stroke. It remains unclear whether the anatomic basis and pathogenesis of pathological crying and laughing is same.