草酸依地普仑抗抑郁作用的特点分析

Antidepressive characteristics of escitalopram oxalate

目的:目前选择性5-羟色胺再摄取抑制剂(selectiveserotoninreuptakeinhibitor,SSRIs)已取代了三环类抗抑郁药物成为抑郁治疗的一线用药,其原因在于它们不仅具有三环类抗抑郁药相似的疗效,同时具有相对较好的耐受性以及过量时较好的安全性,草酸依地普仑是一种新型的SSRIs,它是西酞普兰的右旋体(S-异构体),对血清胺转运体有很强的亲和力,其左旋体无活性。在许多国家已广泛用于抗抑郁障碍及抗焦虑障碍。文章回顾了有关草酸依地普仑药理作用、临床应用及其他方面,分析其抗抑郁作用的特点。资料来源:应用计算机检索Medline数据库2002-01/2004-12期间的相关文章,检索词“escitalopram,限定文章语言种类为英语。同时计算机检索中国期刊全文数据库1980-01/2004-12期间相关文章,检索词“新型抗抑郁药、西酞普兰、依地普仑”,限定文章语言种类为中文。资料选择:对资料进行初审,选取草酸依地普仑与安慰剂、西酞普兰及其他抗抑郁药的临床对照研究、动物实验及其药理作用密切相关的文献,作为纳入标准,必要时查找全文。资料提炼:共收集了54篇关于草酸依地普仑的文章,筛选后纳入20篇。资料综合:20篇文献分别从不同的角度论述了草酸依地普仑的特点。包括临床适应症、作用机制、疗效、药物副反应、耐受性、依从性、剂量,?

OBJECTIVE:Selective serotonin reuptake inhibitors(SSRIs) have become the first-line medication for depression instead of tricyclic antidepressants(TCAs) in recent years.It is because that compared with TCAs,SSRIs have not only the same efficacy,but also relatively better tolerance and better reliability when overdose.Escitalopram oxalate(dextroisomer of citalopram,S-isomer),a new type of SSRIs,has great avidity to high serotonin transporter,and its levo-isomer is not active.It has been widely used for the treatment of depression and anxiety disorders in many countries.This article reviews the pharmacology,clinical application and other aspects of escitalopram,and analyzes its antidepressive characteristics. DATA SOURCES:An online search of Medline database was undertaken by using the keyword of“escitalopram' to identify the relevant articles published in English from January 2002 to December 2004.Meanwhile,Chinese journals full-text database was scanned with computer to search relevant articles published from January 1980 to December 2004,the keywords were “new antidepressants, citalopram,escitalopram' with language limited to Chinese. STUDY SELECTION:The clinical control study of escitalopram with placebo,citalopram and other antidepressants were selected, animal experiment and articles that were closely correlated with its pharmacology were taken as the inclusion criteria,and the full texts were scanned if necessary. DATA EXTRACTION:Fifty-four articles about escitalopram were collected, and 20 of them were involved after screening. DATA SYNTHESIS:The 20 significant articles discussed the characteristics of escitalopram from different angles,including its clinical indications,mechanism,efficacy,adverse effects,tolerance, dependence and dosage,and its advantages over other antidepressants were also summed up. CONCLUSION:Escitalopram is a kind of simple SSRIs,and has the highest relative selectivity of serotonin re-uptake inhabitor among drugs of the same kind,and its antidepressive effect is superior to citalopram.Escitalopram has the advantages of fast effect,small dose,good tolerance,mild adverse effects and fewer drug interaction,it can be used together with other drugs.Escitalopram,as SSRIs,is the first-line therapy in patients with severe depression.