西酞普兰治疗癫癎伴发抑郁38例患者临床观察

Clinical observation of efficacy and safety of citalopram in treatment of depressive patients with epilepsy

目的评估西酞普兰治疗癫痫伴发抑郁的疗效。方法选择癫痫伴发抑郁患者38例,根据年龄分为年轻组(26例)和老年组(12例),患者服用抗癫痫药同时,均加用西酞普兰20 mg/d,持续12周,观察西酞普兰控制抑郁症状的疗效。抑郁症状于第2、4、8和12周末通过汉密尔顿抑郁量表进行评估。结果与用药前比较,两组患者用药后癫痫发作频率均明显下降,抑郁症状显著改善,差异有统计学意义(P<0.05,P<0.01)。与老年组比较,年轻组患者仅用药第2周末抑郁症状下降更显著(P<0.05),其他3个时间点,差异无统计学意义(P>0.05)。21例患者出现头痛、恶心、眩晕、嗜睡和疲乏等副作用。结论通过西酞普兰治疗,患者的抑郁症状得到显著改善,癫痫发作频率下降。

Objective To assess the safety and efficacy of citalopram in treatment of depression in patients with epilepsy. Methods Forty-two depressive patients with epilepsy on antiepileptic drugs took part in the study. Patients who had low frequency of seizures in the 3 previous months underwent treatment with citalopram（20 mg/d） for 12 weeks. Efficacy for controlling depressive symptoms was taken as the primary measure and change in seizure frequency from the baseline was chosen as the secondary measure for assessing the safety of citalopram. Depression was rated according to Hamilton Depression Rating Scale for Depression. Clinical assessment was performed at 2,4,8,12 weekends of citalopram therapy. Results Of the 42 patients,4 dropped out of the study. An overall improvement in seizure frequency was observed in the 38 patients who comple- ted the study. Depressive symptoms improved markedly. Twenty-one patients complained of ad- verse effects, mainly headache, nausea, dizziness, somnolence, and fatigue. Conclusion Treatment with citalopram（20 mg/d） for 12 weeks was associated with an improvement of depressive symptoms and reduction of seizure frequency.