反复发作抑郁症维持治疗剂量的研究

A study of maintenance dosage of amitriptyline in recurrent depression.

将３６例反复发作抑郁症病人随机分为Ａ、Ｂ、Ｃ三组，分别服用不同剂量的阿米替林（日量分别为１７５～２００ｍｇ，１２５～１５０ｍｇ，７５～１００ｍｇ）维持治疗，采用前瞻性、盲法对照研究，进行３～４年的抗复发效果随访，经过生存分析（复发率分析），结果显示：Ａ组与Ｂ组复发率无显著性差异，但Ａ组复发危险性比Ｂ组小１４８％；Ａ组复发孝明显低于Ｃ组，有显著性差异，复发危险性比Ｃ组小１８５％；Ｂ组与Ｃ组无论是复发率还是复发危险性均无显著差异。表明反复发作抑郁症病人的最佳维持剂量为充分治疗量。

AbstractObjectlve:To study the effective dosage of amitriptyline for preventing relapses of recurrent depres-sion,Method:This is a prospective and blind study in which 36 patients with recurrent depression were randomly divided into three groups and received three different dosages of amitriptyline. The daily dosage of amitriptyline was 175-200mg for group A,125-150mg for group B and 75-100mg for group C.The subjects were followed up for 3 to 4 years. Results:Survival rate analysis showed that there was no significant difference of relapse rate between group A and B. But the relapse rate of group A vvas signifi-cantly lower than that of group C. The relapse risk rate(RR)of group A was 148%lower than that of group B,and 185%lower than that of group C. There was no difference of relapse rate and relapse risk rate between groups B and C, Disscussion:It has often been recommended that the most appropriate dosage for preventing relapses of depression was 2/3 to 1/2 times of their therapeutic dosages. Howev-er,this study found that the optimal maintenance dosage of amitriptyline for preventing relapses of re-current depression was equivalent to the therapeutic dosage.