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目的探讨西酞普兰和舍曲林治疗癫痫性抑郁障碍的临床疗效和安全性。方法将62例符合中国精神障碍分类与诊断标准第3版(CCMD-3)癫痫性抑郁障碍患者随机分为两组,在维持原抗癫痫药物的治疗基础上,分别给予西酞普兰和舍曲林治疗,疗程8周。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)于治疗前和治疗1、2、4、6、8周末分别评定疗效和不良反应。结果西酞普兰组起效时间较舍曲林组快,两组相比有显著性差异(P<0.01)。西酞普兰组显效率为80.6%,舍曲林组的显效率为75%,两组比较,无显著性差异(P>0.05)。经8周治疗后,两组HAMD、HAMA评分均较治疗前下降(P<0.05)。组间比较,除治疗后第l周西酞普兰组HAMD、HAMA评分显著低于舍曲林外(P<0.01),其余各次评分两组差异均无统计学意义(P>0.05)。治疗后TESS各时间点评分,西酞普兰组副反应明显低于舍曲林组,差异有统计学意义(P<0.01)。舍曲林组有2例引起癫痫发作次数增加,而西酞普兰对癫痫发作无明显影响。结论西酞普兰治疗癫痫性抑郁障碍疗效肯定,不良反应小,临床上可作为首选药物。
Objective To investigate the clinical efficacy and safety of citalopram and sertraline in the treatment of epileptic depressive disorder. Methods Sixty-two patients with epilepsy and depressive disorder (CCMD-3) who met the criteria of classification and diagnostic criteria of mental disorders in China were randomly divided into two groups. On the basis of the treatment of the original antiepileptic drugs, citalopram and sertraline Lin treatment, treatment for 8 weeks. Efficacy and side effects were assessed before treatment and at the end of the first, second, fourth, sixth, and eighth weeks with the Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Scale (HAMA) and the Side Effects Scale (TESS). Results The effect of citalopram in sevoflurane was faster than that in sertraline group. There was significant difference between the two groups (P <0.01). Citalopram significant efficiency was 80.6%, sertraline group markedly effective rate of 75%, no significant difference between the two groups (P> 0.05). After 8 weeks of treatment, HAMD and HAMA scores of both groups decreased compared with those before treatment (P <0.05). Compared with sertraline, the HAMD and HAMA scores of citalopram group at the first week after treatment were significantly lower than those of sertraline (P <0.01). There was no significant difference between the other groups in the scores of the two groups (P> 0.05). After treatment, TESS score at each time point, citalopram side effects were significantly lower than the sertraline group, the difference was statistically significant (P <0.01). Sertraline group 2 cases caused an increase in the number of seizures, while citalopram no significant effect on seizures. Conclusion Citalopram treatment of epileptic dementia positive effect, small adverse reactions, clinically as the drug of choice.