文拉法辛氟西汀阿米替林治疗抑郁症对照研究

A control study of venlafaxine, fluoxetine and amitriptyline in depression

目的比较文拉法辛、氟西汀、阿米替林治疗抑郁症的临床疗效和安全性。方法将102例抑郁症患者随机分为A、B、C三组各34例，分别口服文拉法辛、氟西汀和阿米替林治疗，观察8w。于治疗前及治疗1w、2W、4w、6w、8w末采用汉密顿抑郁量表、临床疗效总评量表、副反应量表评定临床疗效和不良反应。结果治疗8w末，三组间有效率、汉密顿抑郁量表减分率及临床疗效总评量表评分比较均无显著性差异（P〉0．05）；起效时间依次为A组〈B组〈C组；治疗后A组与B组间不良反应发生率以及各时点副反应量表评分均无显著性差异（P〉0．05），但均显著低于C组（P〈0．01）。结论文拉法辛、氟西汀与阿米替林治疗抑郁症疗效相当，但文拉法辛与氟西汀的起效时间、安全性优于阿米替林。

Objective To compare the clinical efficacies and safety of venlafaxine,fluoxetine and amitriptyline in depression. Methods 102 depression patients were randomly assigned to group A, B and C of 34 ones each and took orally venlafaxine,fluoxetine and amitriptyline separately for 8 weeks. Clinical efficaies were assessed with Hamilton Depression Scale（HAMD） and the Clinical Global Impression（CGI） and adverse reactions with the Treatment Emergent Symptom Scale（TESS） before treatment and at the ends of the 1st,2nd,4th,6th and 8th week treatment. Results At the end of the 8th week, there were no significant differences in effective rates,score-decrement rates and CGI scores among the 3 groups（P〉0.05） ;operating time was in turn group A〈B〈C; after treatment, there were no significant differences in incidences of adverse reactions and TESS scores of each time-point between group A and B（P〉0.05）, but those were significantly lower in both group A and B than C（P〈0.01）. Conclusion Both venlafaxine and fluoxetine have significant efficacy equivalent to amitriptyline in the treatment of depression and an advantage over amitriptyline in action time and safety.