文拉法辛联合喹硫平、奥氮平治疗难治性抑郁症的对照研究

Comparative study of venlafaxine combined with quetiapine or olanzapin in the treatment of treatmentresistant depression

目的探讨文拉法辛联合喹硫平、奥氮平治疗难治性抑郁症的疗效和安全性。方法80例难治性抑郁症患者,随机分为喹硫平组(文拉法辛联合喹硫平)和奥氮平组(文拉法辛联合奥氮平)。疗程8周。采用汉密尔顿抑郁量表(HAMD)评定疗效,同时记录两组不良反应发生情况。结果喹硫平组显效率67.5%,奥氮平组65%,均有显著性疗效,两组间无显著统计学意义(X^2=0.05,P>0.05)。治疗2、4、6、8周后两组HMAD评分较治疗前有显著性降低,且差异具有显著性(P<0.01)。奥氮平组食欲增加及体质量增加者较喹硫平组多,差异有显著统计学意义(X^2=6.27,P=0.01;X^2=4.58,P=0.03)。结论文拉法辛联用喹硫平、奥氮平治疗难治性抑郁症疗效好,起效快。文拉法辛联用喹硫平对食欲及体质量增加影响较小。

Objective To explore the efficacy and safety of venlafaxine combined with quetiapine or olanzapin in treatment-resistant depression（ TRD）. Methods 80 patients with TRD were randomly divided into two combined groups,venlafaxine with quetiapine and venlafaxine with olanzapine,for 8 weeks. Hamilton Rating Scale for Depression（ HAMD） was used to evaluate the clinical efficacy,at the same time recorded the adverse reactions.Results The response rate was 67. 5% in quetiapine group and 65% in olanzapin group. Both of two groups showed remarkable efficacy,and there was no significant difference between the two groups（ χ~2= 0. 05,P〈0. 05）.In both of groups,the scores of 2nd,4th,6th,8th weeks of HAMD were significantly reduced from the baseline and the difference was statistically significant（ P〈0. 01）. In olanzapin group,appetite and body weight gain were more apparent than the quetiapine group. There was significant difference between the two groups（ χ~2= 6. 27,P = 0. 01;χ~2= 4. 58,P = 0. 03）. Conclusion Venlafaxine combined with quetiapine or olanzapin are both good efficacy and work fast in TRD. Venlafaxine combined with quetiapine does less effect on appetite and body weight.