氯胺酮对抑郁症患者艾司西酞普兰抗抑郁的增效作用观察

Synergistic effect of ketamine on antidepressant of escitalopram in depressive patients

目的观察氯胺酮对抑郁症患者艾司西酞普兰抗抑郁的增效作用。方法选取84例抑郁症患者,按随机数表法分为观察组与对照组,各42例。观察组采取氯胺酮联合艾司西酞普兰治疗,对照组单用艾司西酞普兰。比较两组治疗4周的治愈率与有效率及所用时间,治疗前后MARDS评分、总体精神状态、分离症状、躁狂症状、不良反应总发生率。结果观察组治愈率与有效率分别为71.43%、90.48%,均高于对照组(P<0.05)。观察组MARDS评分与BPRS评分从治疗后2 h开始持续下降(P<0.05),观察组治疗后不同时点的MARDS评分、BPRS评分均低于对照组(P<0.05)。两组治疗前后的CADSS评分均无明显变化(P>0.05)。观察组治疗后2h与4h的YMRS评分高于本组治疗前与对照组(P<0.05)。治疗期间两组不良反应总发生率相当(P>0.05)。结论单次低剂量氯胺酮联合艾司西酞普兰治疗抑郁症具有增效作用,利于快速抗抑郁并改善患者总体精神状态,副作用轻微,无明显分离与躁狂症状。

Objective To observe the synergistic effect of ketamine on antidepressant of escitalopram in depressive patients. Methods 82 patients with depression were selected and divided into observation group and control group according to the random number table, 42 cases in each group. The observation group was treated with ketamine combined with escitalopram, and the control group was treated with escitalopram alone. The rates of cure and efficacy after treatment of 4 weeks, the MARDS score, the overall mental state, the isolated symptoms, the manic Symp- toms before and after treatment, the total incidence of adverse reactionswere compared between two groups. Results The cure rate and effective rate of the observation group were 71.43 % and 90.48 %, which were higher than those in control group （ P〈0.05 ） . The MARDS score, BPRS score of observation group decreased from 2 h after treatment （ P〈 0.05 ）, the MARDS score, BPRS scores at different points after treatment in observation group were lower than those in control group （P 〈 0.05 ） . There was no significant change in the scores of CADSS before and after treatment （ P〉0.05 ） . The YMRS score in observation group at 2h and 4h after treatment were higher than those before treatment and those in control group （ P〈0.05 ） . The total incidence of adverse reactions in both groups was comparable （P 〉 0.05 ） . Conclusion A single low-dose ketamine combined with escitalopram treatment of depression with synergistic effect, which is conducive to rapid antidepressant and improve the overall mental state of patients, and mild side effects, no significant separation and manic symptoms.