帕罗西汀合用喹硫平治疗双重抑郁症的随机开放试验

Effects of paroxetine combined with quetiapine in the treatment of double depression

目的:评价帕罗西汀合用喹硫平治疗双重抑郁症的疗效和安全性。方法:将符合中国精神障碍分类与诊断标准第三版(Chinese classification and diagnostic criteria of mental disorders,CCMD-3)双重抑郁症诊断标准的66例门诊及住院患者随机分为两组,研究组(n=34)给予帕罗西汀合用喹硫平治疗,对照组(n=32)给予帕罗西汀治疗,疗程12周。于治疗前和治疗后2、4、6、8、12周分别使用汉密顿抑郁量表(Hanmilton Depression Scale,HAMD)、汉密顿焦虑量表(Hanmilton Anxiety Scale,HAMA)、临床总体印象疗效总评量表的病情严重程度(Clinical Global Impression,CGI)、不良反应量表(Treatment E-mergent Symptom Scale,TESS)评定疗效和不良反应。HAMD总分≤7分为痊愈;HAMD总分>7分,减分率≥50%为好转,痊愈和好转合称有效。结果:治疗前研究组和对照组HAMD、HAMA评分差异无统计学意义(P>0.05)。治疗12周后,研究组和对照组的HAMD、HAMA评分均低于治疗前(Ps<0.05);研究组6、8、12周HAMD、HAMA评分均低于对照组(Ps<0.05);研究组有效率高于对照组(P<0.05);两组间不良反应发生率差异无统计学意义(P>0.05)。结论:帕罗西汀合用喹硫平治疗双重抑郁症疗效较好,安全性高。

Objective：To evaluate clinical efficacy and safety of paroxetine combined with quetiapine in the treatment of double depression.Methods：Sixty-six inpatients and outpatients who met the CCMD-3 diagnostic criteria for double depression were randomized to two groups.The research group（n=34）received paroxetine combined with quetiapine and the control group received paroxetine for 12 weeks.Clinical efficacies and adverse reactions were assessed with the Hanmilton Depression Scale（HAMD）,Hanmilton Anxiety Scale（HAMA）,Clinical Global Impression（CGI）and Treatment Emergent Symptom Scale（TESS）before treatment and at the end of the 2nd,4th,6th,8th and 12th week,respectively.Results：Before treatment there were no significant differences in the scores of both HAMD and HAMA between the two groups（Ps〉0.05）.After 12 week treatment,the scores of the HAMD and HAMA in both groups were lower than those before pretreatment（Ps〈0.05）.At the end of the 6th,8th and 12th week,the scores of both the HAMD and HAMA were lower in the research group than in the control group（Ps〈0.05）.The effective rate was higher in the research group than in control group（71% vs.44%,P〈0.05）.There was no difference of incidences of adverse reactions between the 2 groups（32% vs.25%,P〉0.05）. Conclusions：Paroxetine combined with quetiapine may have a better efficacy and higher safety in the treatment of double depression.