帕罗西汀添加坦度螺酮和丁螺环酮治疗难治性抑郁症的疗效比较

Comparative study of efficacy of Paroxetine augmented with Tandospirone or Buspirone in treatment of treatment- resistant depression

目的:探讨帕罗西汀添加丁螺环酮或坦度螺酮治疗难治性抑郁症(TRD)的疗效和安全性。方法:将74例TRD患者随机分为丁螺环酮组(帕罗西汀联合丁螺环酮,n=37)和坦度螺酮组(帕罗西汀联合坦度螺酮,n=37),治疗8周,采用17项汉密尔顿抑郁量表(HAMD-17)和汉密尔顿焦虑量表(HAMA)评价患者疗效,用副反应量表(TESS)评价患者不良反应。结果:帕罗西汀联合丁螺环酮治疗TRD患者明显优于联合坦度螺酮,且起效较快(P<0.05);两组患者不良反应均轻微且相似(P>0.05)。结论:帕罗西汀联合丁螺环酮治疗TRD起效较快,与丁螺环酮相比,坦度螺酮对添加治疗TRD的增效作用不明显,这可能源于两者对多巴胺D2受体的亲和力不同所致。这些结果仍需进一步研究确定。

Objective：To probe the efficacy and safety of Paroxetine augmented with Tandospirone or Buspirone in treatment of treatment-resistant depression （ TRD） . Methods：74 TRD patients were randomly assigned to Buspirone group （ Paroxetine ＋ Buspirone, n=37） and Tandospirone （Paroxetine ＋ Tandospirone, n=37）, and were treated for 8 weeks. 17-item Hamilton depression scale （HAMD-17） and Hamilton anxiety scale （HAMA） were used to evaluate efficacy. Treatment emergent symptom scale （TESS） was used to evaluate adverse effects. Results：Paroxetine augmented with Buspirone was better than it with Tandospirone in the treatment of TRD, and made a faster onset of action （P〈0. 05）. The adverse effects of the two groups were relatively mild and similar （P〉0. 05）. Conclusions：Paroxetine augmentation with buspirone can make a faster onset of action in the treatment of TRD. Tandospirone is not as significantly effective as Buspirone to promote effects in the add-on treatment of TRD. This may be due to the striking differential affinity to dopamine D2 receptors between them. These findings still need further trials to be confirmed.