奥氮平联合氟西汀治疗精神分裂症后抑郁的随机、双盲对照研究

Randomized double-blind control study of olanzapine augmented with fluoxetine for schizophrenia with depression symptom

目的:观察奥氮平联合氟西汀治疗精神分裂症后抑郁的疗效和副反应.方法:将符合入组标准的100例患者随机分成研究组(奥氮平联合氟西汀治疗)50例,对照组(文拉法辛联合阿立哌唑治疗)50例.于治疗前和治疗第1,6wk末采用汉密尔顿抑郁量表(HAMD)24项、阳性与阴性症状评定量表(PANSS)评定疗效;采用不良反应量表(TESS)评定药物不良反应.结果:研究组抑郁症状消失17例(34.0%),显著改善12例(24.0%),改善15例(30.0%),无效6例(12.0%),有效率88.0%;对照组抑郁症状消失10例(20.0%),显著改善13例(26.0%),改善15例(30.0%),无效12例(24.0%),有效率76.0%.两组间有效率比较有统计学差异(P<0.05).治疗第1wk末研究组HAMD总分、PANSS总分及各因子分下降有统计学差异(P<0.05),而对照组无统计学差异(P>0.05).两组间比较有统计学差异(P<0.01);治疗第6wk末两组HAMD,PANSS总分及各因子分均减少(P<0.05),两组间比较有统计学差异(P<0.05).两组副反应比较有统计学差异(P<0.05).结论:奥氮平联合氟西汀组治疗精神分裂症后抑郁,起效更快,疗效更好,安全性高.

AIM： To explore the efficacy and safety of olanzapine augmented with fluoxetine in treating schizophrenia with depression symptom. METHODS： I00 patients with schizophrenia with depression symptom were randomly divided into study group （olanzapine augmented with fluoxetine） and control group （aripiprazole augmented with venlafaxine ） for 6 week doubleblind study. Before treatment and at the ends of Ist, 6th week of treatment, the clinical curative effects were assessed with the Hamilton Depression Scale （HAMD） and Positive and Negative Syndrome （ PANSS）, adverse effects with the Treatment Emergent Symptom Scale （TESS）. RESULTS： At the end of I st week, scores of the HAMD and PANSS decreased significantly or very significantly for study group （ P 〈 0.05 ）. At the end of 6th week, scores of the HAMD and PANSS decreased significantly or very significantly for both the two groups compared with pretreatment （ P 〈 0.05 or 0.01 ） , in corresponding period those of the research group did more significantly compared with the control group （P 〈0.05 or 0.01 ）. There were significant differences in adverse effects of both groups （ P 〈0.05 ）, study group has less adverse effects than control group. CONCLUSION： Olanzapine augmented with fluoxetine has better efficacy than aripiprazole augmented with venlafaxine in the treatment of schizophrenia with depression symptom. Olanzapine augmented with fluoxetine has superior safety and better medical compliance would be used in clinical practice.