氟西汀与阿米替林治疗卒中后抑郁症的比较

Fluoxetine vs amitriptyline in treatment of poststroke depression

目的：评价国产氟西汀治疗卒中后抑郁症的疗效和安全性。方法：１２７例卒中后抑郁症病人随机分为氟西汀组６３例（男性４３例，女性２０例，年龄６０±ｓ９ａ），用氟西汀２０～４０ｍｇ／ｄ，ｐｏ，阿米替林组６４例（男性４５例，女性１９例，年龄６１±８ａ），用阿米替林２５～５０ｍｇ，ｐｏ，ｔｉｄ。疗程均为６ｗｋ。采用ＨＡＭＤ及ＣＧＩ评定临床疗效，ＴＥＳＳ评定不良反应。结果：治疗６ｗｋ后，ＨＡＭＤ总分显著下降，Ｐ值均＜０．０１。氟西汀组总有效率为９２％，阿米替林组总有效率为９５％。２组疗效差别无显著意义（Ｐ＞０．０５）。氟西汀组不良反应少而轻微（Ｐ＜０．０１）。

AIM: To evaluate the efficacy and safety of domestic fluoxetine in treating poststroke depression (PSD). METHODS: Patients with PSD(n=127) were randomly divided into 2 groups. Fluoxetine group (M 43, F 20, age 60±s 9 a) was treated with fluoxetine 20_40 mg/d, po, for 6 wk. Amitriptyline group (M 45, F 19, age 61±8 a) was treated with amitriptyline 25_50 mg, po, tid for 6 wk. Their symptoms were assessed with Hamilton Depression Scale (HAMD) and Clinical Global Impression (CGI) before and after the treatment. Levels of adverse reaction were determined by Treatment Emergent Symptoms Scale (TESS). RESULTS: Each group reached diminishment on total scores of HAMD(P<0.01). The total response rates of fluoxetine and amitriptyline were 92% and 95% respectively(P>0.05). Adverse reactions of fluoxetine group were rare and mild(P<0.01). CONCLUSION: The domestic fluoxetine has a good efficacy and safety for treatment of PSD.