西酞普兰和氯丙咪嗪治疗惊恐障碍对照研究

Citalopram versus Clomipramine for the Treatment of Panic Disorders-a Double-blind Randomized Study

目的研究氯丙咪嗪和西酞普兰治疗惊恐障碍的有效性和安全性。方法随机对照研究,为期10周的观察,以临床观察及惊恐症状评定量表(PA SS)、汉密尔顿抑郁量表(HAMA)、汉密尔顿焦虑量表(HAM D)等评定临床效果,以副反应量表(TESS)评定不良反应。入组73例(氯丙咪嗪35例,西酞普兰38例),因不良反应而退组5例(氯丙咪嗪4例,西酞普兰组1例),完成者68例(氯丙咪嗪31例,西酞普兰组37例)平均最高剂量为:氯丙咪嗪159.7m g/d,西酞普兰20m g/d(t=1.341,P≤0.05)。结果氯丙咪嗪和西酞普兰显效率分别为62.2%和64.5%,两种药物的效果无明显差异。不良反应发生率,西酞普兰组10.8%,氯丙咪嗪组42.9%。结论西酞普兰是一种疗效好、安全性高的治疗惊恐障碍的药物。

Objective To compare the efficacy and safety of citalopram and clomipramine in the treatment of panic disorder.Method A 10-week multi-centered double-blind randomized study was designed.The efficacy was evaluated by clinical judgment,PASS,HAMA and SDS.The safety was assessed in terms of TESS（t=1.341,P≤0.05）.73 cases of panic disorder were enrolled and 5 cases were withdrawn due to intolerance of side effects：1 case from group of citalopram and 4 cases from group of clomipramine,Among completed cases,37 were in the treatment of citalopram and 31 were in clomipramine.Results According the judgment of clinicians,the marked improved rate was 62.2% for citalopram and 64.5% for clomipramine,there was no significant difference in improved rate between two groups.Citalopram group had much lower incidence of side effect（10.8%）than clomipramine（42.9%）.Conclusion Citalopram is one of efficient and high-safety drugs in treatment of panic disorder.