万拉法新与丙咪嗪治疗老年抑郁症对照研究

A control study of venlafaxine and imipramine in the treatment of senile depression

目的探讨万拉法新与丙咪嗪治疗老年抑郁症的疗效和安全性。方法将符合《中国精神障碍分类与诊断标准》第3版的40例老年抑郁症患者随机分为万拉法新治疗组和丙咪嗪治疗组,疗程6w。采用汉密顿抑郁量表、临床总体印象量表、副反应量表于治疗前和治疗1、2、4、6w末评定临床疗效及副反应。结果万拉法新组显效率75%,丙咪嗪组显效率70%,两组间比较无显著性差异(χ2=0.125,P>0.05)。万拉法新起效较丙咪嗪快,差异有显著性(t=1.98,P<0.05)。万拉法新的副反应以消化道症状和轻度头晕为主,丙咪嗪以抗胆碱能和心血管系统为主,两组差异有显著和极显著性(P<0.05或0.01)。结论万拉法新治疗老年抑郁症与丙咪嗪疗效相当,但起效较丙咪嗪快,且副作用小。

Objective To explore the efficacies and side effects of venlafaxine and imipramine in the treatment of senile depression. Methods 40 senile depressive patients（CCMD-3） were randomly divided into venlafaxine （n=20） and imipramine group （n=20） for 6 weeks. Clinical efficacies and side effects were assessed with the Hamilton Depression Scale（HAMD）,the Clinical Global Impression（CGI） and the Treatment Emergent Symptom Scale（TESS） before treatment and at the end of 1st,2nd 4th and 6th week treatment. Results Effectual rates of venlafaxine and imipramine were 75% and 70% respectively, which showed no significant difference（P〉0.05）; Venlafaxine took effect faster than imipramine did, difference was significant（P〈0.05）. The side effects of venlafaxine were mainly symptoms of digestive tract and mild dizziness and those of imlpramine anticholinergic and cardiovascular symptoms, there was more significant or the most significant difference（P〈0.05 or 0.01）. Conclusion Venlafaxine has a same efficacy to imipramine in the treatment of senile depression, takes effect faster and has fewer side effects.