艾司西酞普兰快速剂量滴定治疗广泛性焦虑障碍的对照研究

Control research on fast up-titration of escitalopram in the treatment of generalized anxiety disorder

目的:观察艾司西酞普兰快速滴定能否加快起效速度及提高8周疗效。方法:将78例符合ICD-10广泛性焦虑障碍的患者随机分成艾司西酞普兰快速滴定组(1周内艾司西酞普兰加量至20mg/d)(n=36)和艾司西酞普兰常规滴定组(2周内艾司西酞普兰加量至20mg/d)(n=42),治疗持续8周,用广泛性焦虑量表-7(GAD-7)评定患者焦虑症状及疗效,同时用TESS和实验室检查评估治疗安全性。结果:治疗1、2、4、8周末快速滴定组GAD-7减分率均大于常规滴定组。第1、2、4、8周末艾司西酞普兰快速滴定组的治愈率分别为11.1%、27.8%、50.0%、72.2%,常规滴定组治愈率分别为2.4%、11.9%、23.8%、50.0%。第1、2、4、8周末艾司西酞普兰快速滴定组的有效率分别为33.3%、50.0%、63.9%、88.9%,常规滴定组有效率分别为11.9%、26.2%、42.9%、66.7%,快速滴定组疗效优于常规滴定组(P<0.05)。两组不良反应差异无统计学意义。结论:艾司西酞普兰快速滴定治疗广泛性焦虑障碍可以加快起效速度,提高8周整体疗效,同时不会显著增加药物不良反应。

AIM:To explore wether fast uptitration of escitalopram can make patients with generalized anxiety disorder(GAD)response quicker and elevate the efficacy by the end of the8 th week.METHODS:78 patients who meet ICD-10 criteria for GAD were divided into escitalopram fast up-titration group(n=36)and normal up-titration group(n=42)randomly.The trial lasted 8weeks.The anxiety status and efficacy was evaluated with GAD-7(Generalized Anxiety Disorder Scale-7)on the baseline,1st,2th,4th,8th weekend respectively and the safety was evaluated by TESS and laboratory examination.RESULTS:The GAD-7scores in fast uptitration group declined quicker than that in normal up-titration group by the end of 1st,2th,4th,8th week(P<0.05)respectively.The remission rate of fast up-titration group were11.1%,27.8%,50.0%,72.2%,and response rate is 33.3%,50.0%,63.9%,88.9%,while the remission rate of normal up-titration group was2.4%,11.9%,23.8%,50.0%,and response rate was 11.9%,26.2%,42.9%,66.7% at the end of 1st,2th,4th,8th weekend.The whole efficacy of fast up-titration group was better than normal up-titration group(P<0.05).The side effects of both groups had no significant difference(P>0.05).CONCLUSION:Fast up-titration of escitalopram demonstrated to be more effective in the treatment of GAD,and response faster,while the safety is similar.