文拉法辛缓释剂与米氮平治疗难治性抑郁症的对照研究

Venlafaxine extended release and mirtazapine in patients with treatment resistant depression

目的:探讨文拉法辛缓释剂与米氮平治疗难治性抑郁症(TRD)的疗效、安全性及不良反应。方法:对68例TRD病人以简单随机抽样方法分成2组,分别给予文拉法辛与米氮平治疗8 wk,用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床疗效总评量表病情严重程度(CGI-SI)评定疗效。结果:文拉法辛组治疗剂量为(196±s 48)mg·d^(-1),显效时间(8±3)d,有效率68%,米氮平组分别为(32±11)mg·d^(-1)、(12±6)d、65%。2组疗效量表评定结果均较治疗前有显著下降,特别是文拉法辛组wk 1和wk 4的HAMA减分率为(33±3)%和(50±3)%,米氮平组为(14±3)%和(31.0±2.3)%,前者下降更为明显。结论:文拉法辛缓释剂和米氮平治疗TRD疗效均较好、安全性高、不良反应少,文拉法辛缓释剂起效更快速,其抗焦虑作用更快、更佳。

AIM： To study the efficacy, safety and adverse reactions of venlafaxine extended release and mirtazapine in patients with treatment resistant depression （TRD）. METHODS： Sixty-eight patients with TRD were randomized into two groups and were given venlafaxine or mirtazapine for 8 weeks. The efficacy were assessed by Hamilton depression scale （HAMD）, Hamilton anxiety scale （HAMA） and clinical global impression scale-severity of illness （CGI-SI） . RESULTS： The average dose of venlafaxine was （ 196 ± s 48） mg·d^-1, the average effective time was （8 ± 3） d, and the effective rate was 68 %. The average dose of mirtazapine was （32 ± 11） mg·d^-1, the average effective time was （12 ± 6） d, and the effective rate was 65 %. The scores after treatment were significantly decreased in both groups. The scores of HAMA were （33 ± 3） % （wk 1） and （50 ± 3） % （wk 4） in venlafaxine group, （14 ± 3） % and （31.0 ± 2.3） % in mirtazapine group. There was significant difference between two groups. CONCLUSION： Venlafaxine extended release and mirtazapine are both equally effective and safe in TRD with less adverse reactions. However, venlafaxine extended release is faster to take effect than mirtazapine.