氟西汀联合奥氮平治疗抑郁症的临床疗效和安全性

Efficacy and safety evaluation of fluoxetine plus olanzapine in the treatment of depression

目的:评价氟西汀联合奥氮平治疗抑郁症的临床疗效和安全性。方法:将符合中国精神障碍分类与诊断标准第3版(CCMD-3)诊断标准的60例抑郁症患者按就诊单双日分成2组,疗程8周;研究组30例,给予氟西汀20mg/d及奥氮平5mg/d口服;对照组30例,单用氟西汀20mg/d;用汉密尔顿抑郁量表(HAMD24项)及不良反应量表(TESS)评定不良反应。结果:治疗8周后,研究组显效率为86.7%,对照组为63.3%,2组间疗效比较,经Ridit分析差异有显著意义(P<0.05);研究组在治疗后1周末起效,对照组在2周末起效;治疗后1～8周末2组间HAMD评分差异有显著意义(P<0.05)。各周末TESS差异均无显著意义(P>0.05)。结论:氟西汀联合奥氮平治疗抑郁症起效快,并能有效改善睡眠障碍和焦虑及躯体化症状,疗效优于对照组,不良反应无明显增加。

Objective To evaluate the efficacy and safety of fluoxetine plus olanzapine regimen in the treatment of depression. Methods A total of 60 patients with depression, diagnosed by Chinese classification of mental disorders-3 （CCMD-3） criteria, were divided into research group and control group. The patients in the research group were treated with fluoxetine（20 mg/d） plus olanzapine（5 mg/d） regimen, and those in control group were treated with fluoxetine（20 mg/d） alone. The efficacy and adverse effects were evaluated by Hamilton depression rating scale for depression （HAMD） and treatment emergent symptom scale（TESS） scoring system, respectively. Results After 8 weeks treatment, the percentage of patients with significant efficacy in research group was 86.7%, and that in control group was 63.3%（Х^2=9.5,P=0.022）. The time to response in research group and control group was 1 week and 2 weeks, respectively. The results of HAMD score demonstrated significant difference between two groups at each weekend during the treatment period. Yet, the results of TESS didn＇t show similar difference. Conclusions The efficacy of fluoxetine plus olanzapine regimen is better than that of fluoxetine alone in the treatment of depression without additional adverse events, expecially in the improvement of sleeping disorder,orexis, as well as the feeling of body discomfort.