卒中后抑郁使用SSRIs类药物安全及有效性比较

Comparison of Safety and Efficacy of SSRIs in Patients with Post-stroke Depression

目的探讨选择性5-羟色胺再摄取抑制剂(SSRIs)类药物治疗脑卒中后抑郁(PSD)的有效性和安全性。方法将符合标准的186例脑卒中后抑郁患者根据用药情况分为氟西汀、帕罗西汀、舍曲林、氟伏沙明、西酞普兰5组,用汉密尔顿抑郁量表(HAMD)和副反应量表(TESS)对治疗前后的情况进行比较分析。结果西酞普兰与舍曲林在治疗第2周即可见疗效。治疗4周后,各组HAMD与治疗前比较,差异有统计学意义(P<0.05),各组间疗效比较,差异无统计学意义(P>0.05)。TESS评分比较,西酞普兰的不良反应和副作用明显少于其他4组,差异有统计学意义(P<0.05)。结论卒中后抑郁选择SSRIs类药物治疗时,西酞普兰由于有较好的抗抑郁作用,且不良反应较少,可以作为治疗脑卒中后抑郁的第一选择。

OBJECTIVE To study the difference in therapeutic effects and side effects of SSRIs in treating Post-stroke Depression（ PSD）. METHODS 186 cases of PSD patients were divided into Fluoxetine,Paroxetine,Sertraline,Fluvoxamine,Citalopram group,then the patients were tested with Hamilton depression scale（ HAMD） and Treatment Emergent Symtom Scale（ TESS） before treatment and at the end of the second weekend,the forth weekend and the eighth weekend. RESULTS There were significant differences with HAMD between before and after the treatment of all of the SSRIs after 4 weeks（ P〈0. 05）,but there was no difference in five groups（ P〈0.05）.TESS showed Citalopram had less side effects than other SSRIs（ P〈0.05）. CONCLUSION Citalopram has the effect of anti-depression and little severity adverse effect,so it can be a effective and safe drug to treat post-stroke depression.