抗抑郁剂治疗双相抑郁症引发转相的研究

Study of switching caused by antidepressant treatment for bipolar depressive disorder

目的比较不同抗抑郁剂治疗双相抑郁症引发转相的差异。方法选择150例接受双作用抗抑郁剂(DAA)、5-羟色胺再摄取抑制剂(SSRI)或DAA联合SSRI抗抑郁治疗而出现躁狂、轻躁狂及快速循环情况的双相抑郁症患者进行研究,比较不同抗抑郁剂引发转相的差异。结果 150例双相抑郁症中,总体转相率为27.3%,转相与未转相患者的心境稳定剂的联合率比较差异有统计学意义(χ2=11.72,P<0.01)。DAA联合SSRI的转相率高于单用SSRI与DAA,差异有统计学意义(χ2=16.06,P<0.01;χ2=3.49,P<0.05);DAA的转相率高于SSRI,差异有统计学意义(χ2=4.65,P<0.01)。结论抗抑郁剂联合治疗的转相率高,而联合应用心境稳定剂有助于预防转相。

Objective To compare the difference of switching caused by antidepressant treatment for bipolar depressive disorder.Methods 150 patients with bipolar depressive disorder were selected and investigated.They were administrated with antidepressant treatment of dual action antidepressants（DAA）,selective serotonin reuptake inhibitor（SSRI） or DAA combined with SSRI,and accompanied by mania,hypomania and rapid cycling status.The differences of switching caused by different antidepressants were compared.Results The overall switching rate was 27.3% among 150 patients with bipolar depressive disorder.Compared with the combination rates of mood stabilizing agents of switching and non-switching patients,the difference was statistically significant（χ2=11.72,P0.01）.The switching rates of DAA combined with SSRI treatment were higher than those of SSRI or DAA treatment,with statistically significant difference（χ2=16.06,P0.01;χ2=3.49,P0.05）,and the switching rates of DAA were higher than those of SSRI with statistically significant difference（χ2=4.65,P0.01）.Conclusion Antidepressant combination treatment possesses high switching rate,and mood stabilizing agents contribute to preventing the switching.