不同剂量阿立哌唑联合舍曲林治疗抑郁症86例临床分析

A comparative study of different doses of aripiprazole combined with sertraline in the treatment of depression

目的探讨不同剂量阿立哌唑辅助治疗抑郁症的临床疗效及其安全性。方法将86例抑郁症患者随机分为对照组22例,阿立哌唑5mg组24例,阿立哌唑10mg组21例,阿立哌唑15mg组19例,四组均以舍曲林为主抗抑郁治疗,后三组分别给予阿立哌唑5mg、10mg、15mg作为辅助治疗,观察8周。于治疗前和治疗2周、4周、6周、8周末采用汉密顿抑郁量表(HAMD)评定疗效,副反应量表(TESS)评定不良反应。结果阿立哌唑15mg组完成率仅为21.1%,脱落率与其他三组比较差异有统计学意义(P<0.01),而5mg组、10mg组的完成情况和对照组差异无统计学意义(P>0.05)。对照组、5mg组和10mg组治疗后2周、4周、8周末HAMD总分较治疗前均有明显下降,差异有统计学意义(P<0.05)。在完成了8周治疗后,对照组、5mg组和10mg组的疗效总体相似,差异无统计学意义(P>0.05),但治疗第2周末5mg组和10mg组HAMD评分较对照组明显降低,差异有统计学意义(P<0.05)。不良反应监测,高剂量组头痛、静坐不能发生率要高于低剂量组和对照组,差异有统计学意义(P<0.05)。结论阿立哌唑联合舍曲林治疗抑郁症可提高抗抑郁的起效速度,同时阿立哌唑的剂量建议使用小剂量。

Objective To compare the efficacy and safety of different doses of aripiprazole combined with sertraline in the treatment of depression.Methods Eighty-six patients with depression were divided into four groups：control group （n=22）,aripiprazole 5 mg group （n=24）,aripiprazole 10 mg group （n=21）,and aripiprazole 15 mg group （n=19）,The two groups were given aripiprazole 0 mg,5 mg,10 mg,15 mg as adjunctive therapy based on sertraline for 8 weeks,respectively.The efficacy was assessed by Hamilton depression rating scale （HAMD） and the safety was assessed by Treatment Emergent Symptom Scale （TESS） before treatment,at the end of 2nd,4th,6th,8th week of treatment.Results The Aripiprazole 15 mg group completed only 21.1％,and its dropout rate showed statistically significant difference with other groups （P＜0.01）,while the completion status ofAripiprazole 5 mg group,Aripiprazole 10 mg group was not significantly different from that of the control group （P＞0.05）.The HAMD total scores of the control group,Aripiprazole 5 mg group and Aripiprazole 10 mg group at the end of 2nd,4th,8th week of treatment were significantly reduced compared with before treatment （P＜0.05）.After 8 weeks of treatment,the overall efficacy in the control group,Aripiprazole 5 mg group and Aripiprazole 10 mg group showed no statistically significant difference （P＞0.05）,but the scores in Aripiprazole 5 mg group and Aripiprazole 10 mg group at the end of 2nd week was significantly lower than those in the control group （P＜0.05）.The incidence of adverse reactions,such as headache and akathisia,in high-dose group was significantly higher than the low-dose group and the control group （P＜0.05）.Conclusion Aripiprazole combined with sertraline in the treatment of depression can increase the speed of onset of antidepressant,and we recommend small dose.