抗抑郁药物治疗抑郁发作3个月引发转躁的前瞻性观察

Prospective observation of switching rate of antidepressants in management of depressive episode in 3 months

目的前瞻性探讨抗抑郁药物在治疗抑郁发作过程中出现转相的几率。方法对符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)和《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)中抑郁发作或双相抑郁诊断标准的190例接受抗抑郁药物治疗的抑郁发作患者,在医生针对性选择抗抑郁药物治疗情况下进行为期3个月的前瞻性观察,评价转相发生率。结果 1 3个月的治疗中,190例患者转相18例,转相率为9.47%。2男性患者转相率为6.56%,女性患者转相率为10.85%,差异无统计学意义(χ2=0.89,P>0.05)。3单相抑郁与双相抑郁患者转相率分别为5.88%和40.00%,差异有统计学意义(χ2=24.29,P<0.01)。4应用心境稳定剂与未使用心境稳定剂者转相率分别为13.8%和8.44%,差异无统计学意义(χ2=1.47,P>0.05)。5服用2种或2种以上抗抑郁药物者与仅服用一种抗抑郁药物者转相率分别为12.96%和8.08%,差异无统计学意义(χ2=1.07,P>0.05)。6有心境障碍家族史者与无心境障碍家族史者转相率分别为18.4%和7.23%,差异有统计学意义(χ2=4.43,P<0.05)。7转相时间大约在用药后一个月左右。8各种抗抑郁药物转相几率差异不明显。结论抑郁发作患者在抗抑郁药物治疗下会出现一定比例的转相。

Objective To observe prospectively of switching rate of antidepressants in management of depressive episode. Methods 190 patients with depressive episode treated by antidepressants were observed for 3 months and switching rate were assessed under psychiatrist selection without limitation. Results 118 of 190 patients was found to switch in 3 month therapy. The switching rate was9. 47%. 2There is no significant difference in switching rate between the male and the female( 6. 56%,10. 85%,χ2= 0. 89,P >0. 05). 3There is no significant difference in switching rate between unipolar depression and bipolar depression( 5. 88%,40%,χ2=24. 29,P < 0. 01). 4 There is no significant difference in switching rate between patients token mood stabilizer and patients not token mood stabilizer( 13. 8%,8. 44%,χ2= 1. 47,P > 0. 05). 5There is no significant difference in switching rate between patients token more two antidepressants and patients token single antidepressant( 12. 96%,8. 08%,χ2= 1. 07,P > 0. 05). 6There is no significant difference in switching rate between patients with family history of mood disorder and patients without family history of mood disorder( 18. 4%,7. 23%,χ2= 4. 43,P < 0. 05). 7The switching often carry out at one month after treatment with antidepressants. 8The significant difference in switching rate among various antidepressants were not found. Conclusion Some depressive patients may switch during treatment with antidepressant.