艾司西酞普兰联合小剂量喹硫平治疗难治性抑郁症患者的对照研究

A comparative study of escitalopram combined with small dose quetiapinefor patients with treatment-resistant depression

目的探讨草酸艾司西酞普兰联合富马酸喹硫平在治疗难治性抑郁症方面的临床疗效和安全性。方法将70例在门诊和住院收集的符合要求的难治性抑郁症患者,随机分成两组,每组35例,研究组服用草酸艾司西酞普兰联合小剂量富马酸喹硫平,对照组单用草酸艾司西酞普兰,观察期共8周。并于治疗前和治疗后的第2、4、6、8周均采用17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)评价各组的疗效,同时使用副反应量表(TESS)评定治疗期间的不良反应。结果治疗后两组HAMD、HAMA的评分较治疗前均显著下降(P<0.01);同期研究组各项评分结果较对照组下降更显著(P<0.001),第8周研究组和对照组有效率分别是82.86%、60.0%,两组间疗效差异有统计学意义(P<0.01)。两组药物不良反应发生率差异无统计学意义(P>0.05)。结论对于难治性抑郁症,草酸艾司西酞普兰联合小剂量富马酸喹硫平与单用艾司西酞普兰相比,起效较快,并能改善夜眠和焦虑症状,且安全性较好。

Objective To explore the clinical efficacy and safety of escitalopram combined with small dose quetiapine for patients with treatment-resistant depression(TRD).Methods 70 outpatient and hospitalized patients with TRD who met requirements were randomly divided into two groups,with 35 cases in each group.Study group were given escitalopram combined with small dose quetiapine,and control group were given only escitalopram.And both groups were observed for 8 weeks.In addition,17 Hamilton Depression Scale(HAMD-17)and Hamilton Anxiety Scale(HAMA)were used to evaluate the efficacy of each group before treatment and at the 2nd,4th,6th,8th week after treatment.At the same time,Treatment Emergent Symptom Scale(TESS)was used to assess the adverse reactions during the treatment.Results After treatment,the scores of HAMD and HAMA in the two groups were significantly lower than those before treatment(P<0.01),and the scores in the study group decreased more significantly than those in the control group during the same period(P<0.001).The effective rate of treatment in the study group and the control group was respectively 82.86%and 60.0%at the 8th week,difference between the two groups was statistically significant(P<0.01).There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion For patients with TRD,compared with escitalopram alone,escitalopram combined with small dose quetiapine can work quickly,it can improve night sleep and anxiety symptoms,and has better safety.