阿米替林维持治疗抑郁症剂量选择的研究

An experimental study on dosage selection of amitriptyline for maintenance treatment of depression

为探讨抑郁症维持治疗的合适剂量,作者将符合中国精神疾病分类与诊断标准第二版的诊断标准的抑郁症36例,随机分为 A(13例)、B(12例)、C 组(11例)三组,分别服用175～200mg、125～150mg、75～100mg 阿米替林维持治疗,以 Hamilton 抑郁量表、大体评定量表、临床疗效总评量表的病情严重程度、副反应量表为评定指标,对抗复发效果进行3～4年的前瞻性、对照研究。结果显示,A 组复发翠明显低于 C 组(P<0.05),复发危险性比 C 组小185%。A 组与 B 组复发率无显著性差异(P>0.05),但复发危险性比 B 组小148%。4年缓解率 A 组为60.0%,B 组为16.2%,C 组为8.6%。三组副反应无显著性差异(P>0.05)。提示充分治疗量可能是抑郁症维持治疗的最佳剂量。

The purpose of this study was to determine the suitable dosage of amitriptyline for main- tenance treatment of depression.36 depressive patients in accordance with CCMD-2 depression creteria were divided at randon into 3 groups which consisted of 13,12 and 11 patients respectively.The corre- sponding dosages were as follows:group A each patient using amitriptyline 175～200mg/d,group B each patient using 125～150mg/d,and group C each patient using 75～100mg/d.A prospective,com- parative study on preventing the relapse of depression for 3 to 4 years was carried out making use of the scores of HAMD,GAS,CGI-SI and TESS.Results:The relapse rate of group A was significantly low- er than that of group C(P<0.05).The risk rate of relapse of group A was lower 185% than group C. No difference of relapse rate between group A and B was found(P>0.05).The risk rate of relapse of group A was lower 148% than group B.The recovery rate in 4 years of group A was 60.0%,that of group B was 16.2%,and that of group C was 8.6%.No difference of side effects among 3 groups was found (P>0.05).The authors was of opinion that the original adequate therapeutic dosage of amitriptyline for the maintenance treatment of depression might he the most favourable and effective dosage in preventing the relapse of depression.