奥卡西平联合选择性5-羟色胺再摄取抑制剂治疗激越性抑郁的开放性研究

An open study of oxcarbazepine combined with selective serotonin re-uptake inhibitor in treating outpatients with agitated depression

目的 观察和评价门诊32例激越性抑郁患者在应用选择性5-羟色胺再摄取抑制剂（SSRI）的基础上联合应用奥卡西平的效果与不良反应.方法 对符合抑郁症诊断标准同时伴有激越症状的32例患者在应用SSRI的基础上联合应用奥卡西平（0.3 g/片,第1、2天1片,第3天起2片,7 d内根据情况用至4～5片）治疗,观察8周,应用汉密尔顿抑郁评定量表（HAMD）、汉密尔顿焦虑评定量表（HAMA）、杨氏躁狂评定量表（YMRS）评价疗效和不良反应.结果 32例患者奥卡西平平均用量为（1020±65）mg/d.临床有效率为87.5%（28/32）,痊愈率为65.6%（21/32）.治疗后1周、2周、4周、8周的有效率和痊愈率分别是28.1%（9/32）与6.3%（2/32）、37.5%（12/321与12.5%（4/32）、46.9%05/32）与31.3%（10/32）、90.6%（29/32）与65.6%（21/32）.患者治疗后1周、2周、4周、8周的各量表评分与治疗前比较差异均有统计学意义（P〈0.05）.32例患者中没有1例出现转躁狂现象.结论 奥卡西平联合SSRI治疗激越性抑郁可获得较好的疗效.

Objective To observe the efficacy and safety of oxcarbazepine combined with selective serotonin re-uptake inhibitor （SSRI） in the treatment of outpatients with agitated depression. Methods Thirty-two outpatients with agitated symptoms meeting CCMD-3 depression criteria were treated with oxcarbazepine combined with SSRI for 8 w： the dosage of oxcarbazepine changed dairy （1^st and 2^nd, 0.3 g; 3^rd, 0.6 g; 7^th and 8^th, 1.2-1.5 g）. The efficacy and side effects were assessed by Hamilton depression scale, Hamilton anxiety rating scale and Young manic-state rating scale. Results The mean dosage of oxcarbazepine in 32 patients was （1020±65） mg/d. Their mean effective rate and full remission rate 87.5% and 65.6%, respectively. The mean effective rate and full remission rate 1, 2, 4 and 8 w after the treatment were 28.1% （9/32） and 6.3% （2/32）, 37.5% （12/32） and 12.5% （4/32）, 46.9% （15/32） and 31.3% （10/32）, and 90.6% （29/32） and 65.6% （21/32）, respectively. The scores of the above scales 1, 2, 4 and 8 w after the treatment were significantly different with those before the treatment （P〈0.05）. Phase inversion was not found in these 32 patients. Conclusion The oxcarbazepine combined with SSRI maybe one of the better ways in the treatment of patients with agitated depression.