万拉法辛与丙咪嗪治疗抑郁症对照研究

A Comparative Study of Venlafaxine and Imipramine in the Treatment of Patients with Depression

目的 :探讨万拉法辛治疗抑郁症的疗效及副作用。方法 :按随机法分为治疗组和对照组 ,分别服用万拉法辛胶囊和丙咪嗪 ,始服剂量均为 75mg·d 1,根据患者病情及耐受情况在 10d内渐增至 15 0～ 2 2 5mg·d 1,分 3次口服。用四级临床疗效和汉密尔顿忧郁分级量表 (HAMD)观察疗效 ,副作用量表 (TESS)观察副作用。结果 :二者疗效相当 ,万拉法辛起效快于丙咪嗪 ,副作用发生率及严重程度显著少于丙咪嗪 (P <0 .0 1)。结论 :万拉法辛具有较好疗效 ,副作用少 ,较安全 ,除价格较贵外 ,不失为一种新型抗抑郁药 ,尤其适用于年龄较大 ,伴有心血管疾病患者。

Objective:To probe into the therapeutic effectiveness and side effects of venlafaxine in the treatment of patients with depression. Methods:Patients with depression were randomly divided into group A(venlafaxine group) and group B(imipramine group, as control). Patients of group A and group B were treated with venlafaxine capsules and imipramine, repectively. The initial doses of the remedies in both groups were 70 mg·d 1 . According to the state of illness and drug tolerance of the patients, the doses of the remedies were gradually increased to 150～225 mg·d 1 within 10 days. The drugs were taken per os in 3 divided doses per day. The therapeutic effectiveness was assessed according to the 4 grade chinical curative effect and the table of graded levels of depression designed by Hamilton (HAMD). Side effects were appraised by the Table of Side Effect Levels (TESS). Results:The therapeutic effects of both drugs were similar. However, venlafaxine started to act earlier, and the incidence and severity of side effects in patients treated with venlafaxine were apparently lower than those in patients taking imipramine (P<0.01). Conclusion:Venlafaxine has a fairly good curative effect in the treatment of patients with depression, its side effects are rarely encountered. After all, despite its relatively high price, it is a new and safe antidepressant suitable in particular for elderly patients and those with concomitant cardiovascular diseases.