帕罗西汀添加坦度螺酮和丁螺环酮治疗难治性抑郁症的疗效比较

摘要

目的：探讨帕罗西汀添加丁螺环酮或坦度螺酮治疗难治性抑郁症( TRD)的疗效和安全性。方法：将74例TRD患者随机分为丁螺环酮组(帕罗西汀联合丁螺环酮,n=37)和坦度螺酮组(帕罗西汀联合坦度螺酮,n=37),治疗8周,采用17项汉密尔顿抑郁量表(HAMD-17)和汉密尔顿焦虑量表(HAMA)评价患者疗效,用副反应量表(TESS)评价患者不良反应。结果：帕罗西汀联合丁螺环酮治疗TRD患者明显优于联合坦度螺酮,且起效较快(P<0.05)；两组患者不良反应均轻微且相似(P>0.05)。结论：帕罗西汀联合丁螺环酮治疗TRD起效较快,与丁螺环酮相比,坦度螺酮对添加治疗TRD的增效作用不明显,这可能源于两者对多巴胺D2受体的亲和力不同所致。这些结果仍需进一步研究确定。%Objective:To probe the efficacy and safety of Paroxetine augmented with Tandospirone or Buspirone in treatment of treatment-resistant depression ( TRD) . Methods:74 TRD patients were randomly assigned to Buspirone group ( Paroxetine + Buspi-rone, n=37) and Tandospirone (Paroxetine + Tandospirone, n=37), and were treated for 8 weeks. 17-item Hamilton depression scale (HAMD-17) and Hamilton anxiety scale (HAMA) were used to evaluate efficacy. Treatment emergent symptom scale (TESS) was used to evaluate adverse effects. Results:Paroxetine augmented with Buspirone was better than it with Tandospirone in the treat-ment of TRD, and made a faster onset of action (P<0. 05). The adverse effects of the two groups were relatively mild and similar (P>0. 05). Conclusions:Paroxetine augmentation with buspirone can make a faster onset of action in the treatment of TRD. Tandospi-rone is not as significantly effective as Buspirone to promote effects in the add-on treatment of TRD. This may be due to the striking differential affinity to dopamine D2 receptors between them. These findings still need further trials to be confirmed.