不同剂量文拉法辛与阿戈美拉汀联合应用治疗难治性抑郁症的临床效果

Clinical effect of different doses of Venlafaxine combined with Agomelatine in the treatment of refractory depression

目的探讨不同剂量文拉法辛与阿戈美拉汀联合应用治疗难治性抑郁症的临床效果。方法选取2016年4月~2018年3月深圳市康宁医院情感障碍科收治的82例难治性抑郁症患者作为研究对象,采用随机数字分组法将其分为观察组和对照组,每组各41例。两组患者均在1周药物清洗后,服用阿戈美拉汀片进行治疗。对照组患者在此基础上采用文拉法辛75~150 mg/d治疗,观察组患者的文拉法辛剂量控制在150~300 mg/d。治疗7周后,比较两组患者的疗效以及头痛、心悸、头晕、恶心、嗜睡、便秘等不良反应发生率。结果治疗后,观察组患者的治疗总有效率为92.68%,高于对照组的65.85%,差异有统计学意义(P<0.05)。观察组患者的头痛、心悸、头晕、恶心、嗜睡、便秘等不良反应总发生率为14.64%,与对照组的12.20%比较,差异无统计学意义(P>0.05)。结论根据患者治疗情况,在治疗过程中将文拉法辛剂量控制在150~300 mg/d范围,并尽量增加剂量,联合阿戈美拉汀治疗难治性抑郁症,效果显著,且不增加药物的不良反应风险,治疗安全性高,值得在临床推广应用。

Objective To investigate the clinical effect of different doses of Venlafaxine and Agomelatine in the treatment of refractory depression.Methods A total of 82 patients with refractory depression who were admitted to the Department of Affective Disorders in Kangning Hospital of Shenzhen City from April 2016 to March 2018 were selected as study subjects.The patients were divided into observation group and control group,with 41 cases in each group.Patients in both groups were treated with Agomelatine Tablets after 1 week of drug washing.On this basis,patients in the control group were treated with Venlafaxine at 75-150 mg/d,while patients in the observation group were treated with Venlafaxine at 150-300 mg/d.After 7 weeks of treatment,the efficacy and incidence of adverse reactions such as headache,palpitations,dizziness,nausea,drowsiness and constipation were compared between the two groups.Results After treatment,the total effective rate of the observation group was 92.68%,which was higher than that of the control group(65.85%),the difference was statistically significant(P<0.05).The total incidence of adverse reactions such as headache,palpitations,dizziness,nausea,lethargy,and constipation in the observation group was 14.64%,compared with the control group(12.20%),the difference was not statistically significant(P>0.05).Conclusion According to the patients'treatment,the dose of Venlafaxine is controlled in the range of 150-300 mg/d during the treatment,and the dose is increased as much as possible.In combination with Agomelatine in the treatment of refractory depression,the curative effect is remarkable,and the drug risk of adverse reactions is not increased,with high therapeutic safety,which is worthy of clinical application.