奥氮平和丙戊酸钠治疗双相抑郁的疗效及安全性

摘要
图/表
参考文献
相关文章 (5)

全文: PDF (629 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨奥氮平和丙戊酸钠治疗双相抑郁的疗效及安全性。方法时长8周的随机双盲对照研究。将69例符合DSM-IV双相抑郁诊断标准的患者随机分为奥氮平组与丙戊酸钠组,在基线和治疗期每周末采用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、蒙哥马利抑郁量表(MADRS)、贝克-拉范森躁狂评定量表(BRMS)、临床疗效总评量表(CGI-I)和治疗不良反应(TESS)进行评定。结果两组治疗后HAMD、HAMA评分均较治疗前显著降低(P<0.01),两组间减分率差异无统计学意义,奥氮平组和丙戊酸钠有效率分别为82.86％、82.35％,痊愈率为37.14%、38.24%,有效率及痊愈率差异均无统计学意义,但奥氮平起效更为迅速。结论奥氮平可有效治疗双相抑郁。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	汪静
	苏亚玲

关键词 ：奥氮平, 丙戊酸钠, 双相抑郁

Abstract：Objective To assess the efficacy and safety of olanzapine andsodium valproate monotherapy for bipolar depression. Methods Seventy-one patients who met DSM-IV criteria for bipolar depression were randomly assigned to treatment with olanzapine (n=35) or sodium valproate(n=36) in a double-blind parallel-group study design. The treatment duration was 8weeks.Planned assessments included Bech-Rafaelsen Mania Rating Scale(BRMs), Clinical Global Impressions-Improvement Scale (CGI-I), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Treatment Emergent Symptom Scale(TESS). Results Improvements in MADRS total score, CGI-I, and HAMD in the olanzapine group were not significantly different relative to those in the sodium valproate during the 8-week follow-up period (P<0.01, P=0.0017, P=0.007, and P<0.01, respectively).The rate of response(82.86％ and 55.88％,respectively)and remission(37.14％ and 26.47％,respectively)in olanzapine group and sodium valproate group,showed no statistically significant difference. But,olanzapine-treated group had a more rapid onset of effect than sodium valproate-treated patients in score of HAMA,with significant difference between two groups(P<0.01). Conclusions Olanzapine monotherapy is effective in the treatment of bipolar depression.

Key words： olanzapine bipolar depression sodium valproate

收稿日期: 2014-12-22

ZTFLH:

R749.053

作者简介: 汪静,硕士,主治医师,E-mail:tiantian1997521@126.com

引用本文:

汪静, 苏亚玲. 奥氮平和丙戊酸钠治疗双相抑郁的疗效及安全性[J]. 武警医学, 2015, 26(5): 469-472. WANG Jing, SU Yaling. Efficacy and safety of olanzapine and sodium valproate monotherapy in the treatment of bipolar depression:a flexible-dose randomised,double-blind study. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(5): 469-472.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2015/V26/I5/469

[1]	金卫东,陈炯,王鹤秋,等.抗抑郁药物引起双相抑郁患者转相的单因素研究及回归分析[J].中国行为医学科学,2007,16(5):416-417.
[2]	American Psychiatry Association.Practice for the treatment of patients guideline with bipolar disorder(Revision)[J].Am J Psychiatry,2002,159(suppl4):1-50.
[3]	钱正康,杜向东,梅其一,等 .奎硫平与碳酸锂单药治疗双相抑郁的随机双盲对照研究[J].四川精神卫生,2009,22(2):199-202.
[4]	Yatham L N,Goldstein J,Vieta E,et al.Atypical antipsychotics in bipolar depression:potential mechanisnm of action[J].Clin Psychiatr,2005,66(Suppl 5):40-48.
[5]	Hideaki K, Yasushi T, Mauricio T, et al. Efficacy and safety of olanzapine in the treatment of Japanese patients withbipolar I disorder in a current manic or mixed episode: a randomized,double-blind, placebo- andhaloperidol-controlled study[J].J Affect Disord, 2012,136(3): 476-484.
[6]	吴彦,杨杰,施慎逊,等.非典型抗精神病药物治疗双相抑郁[J].上海医药,2012,33(17):7-9.
[7]	Todd M. Valproate or olanzapine add-on to lithium: An 8-week, randomized, open-label study in Italian patients with a manic relapse[J]. J Affect Disord, 2007,99(1-3):247-251.
[8]	Judith W, Alastair F, Barnett M, et al. Factors associated with non-completion in a double-blind randomized controlled trial of olanzapine plus sertraline versus olanzapine plus placebo for psychotic depression[J].Psychiatry Research,2012,197(3): 221-226.
[9]	Todd M. Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cycling[J].J Affect Disord, 2003,73(1): 155-161.
[10]	Tohen, M, McDonnell D P, Case M, et al. A Randomised, double-blind, placebo-controlled study of olanzapine in patients with bipolar I depression[J]. Brit J Pharmacol,2011, 3:376-382.
[11]	Tohen M, Vieta E, Calabrese J, et al. Efficacy of olanzapine and olanzapine- fluoxetine combinationin the treatment of bipolar I depression [J].Archi of Gene Psych,2011,60:1079-1088.
[12]	Hirose S,Ashby C R. An open pilot study combining risperidoneand a selective serotonin reuptake inhibitor as initial antidepres-sant therapy[J].Clin Psychiatry,2002,63:733-736.
[13]	Tohen M, Katagiri H, Fujikoshi S,et al. Efficacy of olanzapine monotherapy in acute bipolar depression: A pooled analysis of controlled studies [J].J Affect Disord, 2013,149(1-3):196-201.
[14]	Man Wang , JianhuaTong,Desheng Huang,et al. Efficacy of olanzapine monotherapy for treatment of bipolar I depression:a randomized,double-blind,placebocontrolled study [J].Psychopharmacology,2014,1:31-32.
[15]	Corya S, Auderseu H, Detke L, et al. Long-term use of olanzapine/fluoxetinecombination for major depressive disorder:a 76-week study[J].Eur Neuropsychopharmacology, 2003,13(Supplement 4):S207.
[16]	Hideaki K, Mauricio T, David P, et al. Safety and efficacy of olanzapine in the long-term treatment of Japanese patients with bipolar I disorder, depression:An integrated analysis [J]. Psych Clin Neuros, 2014,2:65-68.