安非他酮联用碳酸锂缓释片治疗双相抑郁的对照研究

中国临床药理学与治疗学 ›› 2011, Vol. 16 ›› Issue (9): 1042-1046.

安非他酮联用碳酸锂缓释片治疗双相抑郁的对照研究

沈仲夏, 钱敏才, 沈鑫华, 陈海支, 林敏

浙江省湖州市第三人民医院,湖州 313000,浙江

收稿日期:2011-07-13 修回日期:2011-08-24 出版日期:2011-09-26 发布日期:2011-10-11
作者简介:沈仲夏,男,硕士在读,医师,研究方向:抑郁焦虑的临床治疗及生物学基础研究。Tel: 13867291596 E-mail: snowszx@sina.com.cn

The control research of Bupropion combined with Lithium Carbonate in the treatment of bipolar depression

SHEN Zhong-xia, QIAN Ming-cai, SHEN Xing-hua, CHEN Hai-zhi, LIN Min

The Third People's Hospital of Huzhou City, Huzhou 313000, Zhejiang, China

Received:2011-07-13 Revised:2011-08-24 Online:2011-09-26 Published:2011-10-11

摘要/Abstract

摘要： 目的: 探讨安非他酮联用碳酸锂缓释片治疗双相抑郁的疗效及安全性。方法: 进行8周开放式前瞻性随机对照研究,将78例符合《精神疾病诊断与统计手册》第4版(DSM-IV)双相抑郁诊断标准的住院患者随机分成观察组(安非他酮联用碳酸锂缓释片治疗,n=40)及对照组(单用碳酸锂缓释片治疗,n=38),分别在基线及1、2、4、8周末应用汉密尔顿抑郁量表(HAMD-17)评定疗效,同时应用Bech-Rafaelsen躁狂量表(BRMS)评定转躁情况,用治疗中出现的症状量表(TESS)及实验室检查评定不良反应。结果: 8周末两组HAMD总分(8±3,8±4)与基线(24±7,25±8)相比均明显降低(P<0.01),两组间HAMD总分比较差异无统计学意义(P>0.05)。第1、2周末观察组的HAMD总分(21±7,12±5)分别低于对照组(25±8,16±6)(P<0.05)。同时观察组第2周末的有效率(30%)及治愈率(20%)亦明显高于对照组的 10.5%、2.6%(P<0.05)。第4、8周末时观察组HAMD总分分别为9±4、8±3,与对照组(9±5,8±4)比较无统计学差异(P>0.05),同时第8周末两组有效率(90% vs 89.5%)及治愈率(62.5% vs 60.5%)比较亦无统计学差异(P>0.05)。两组间不良反应类似,研究过程中两组均无病例转躁。结论: 安非他酮联用碳酸锂缓释片及单用碳酸锂缓释片治疗双相抑郁均安全有效,安非他酮联用碳酸锂缓释片治疗双相抑郁可加快起效速度,同时并不增加转躁风险。

关键词: 安非他酮, 碳酸锂缓释片, 双相抑郁

Abstract: AIM: To explore the efficacy and safety of Bupropion combined with Lithium Carbonate in the treatment of bipolar depression. METHODS: An open prospective randomized study was applied in this research which lasted 8 weeks. 78 inpatients meet the diagnosis criteria of DSM-IV were divided into two groups, one group(the research group, n=40) were treated with Bupropion combined with Lithium Carbonate, the other group(the control group, n=38) were treated with Lithium Carbonate only, HAMD-17 was applied to evaluate the efficacy on the baseline and the end of 1st, 2nd, 4th, 8th week,the BRMS was applied to evaluate the mania state, while the TESS and laboratory tests were applied to evaluate the side effects. RESULTS: HAMD scores of both group declined significantly at the end of 4th and 8th week respectively (P<0.01), but there were no significant difference between two groups(P>0.05). HAMD scores of research group were lower than those of control group at the end of 1st, 2nd week (P<0.05). There were no significant difference at the end of 8th week of remission rate and response rate between two groups(90% vs 89.5%,62.5% vs 60.5%,P>0.05), while the research group had a greater rate at the end of 2nd week(30% vs 10.5%, 20% vs 2.6%,P<0.05). There were no significant difference in side effects and cases switching to mania between two groups. CONCLUSION: Either Bupropion combined with Lithium Carbonate or Lithium Carbonate only would be effective and safe for bipolar depression, but the former can cut down the initial time to become effective and would not increase the risk of turning to mania.

Key words: Bupropion, Lithium Carbonate sustained release tablets, Bipolar depression

中图分类号:

R749

沈仲夏, 钱敏才, 沈鑫华, 陈海支, 林敏. 安非他酮联用碳酸锂缓释片治疗双相抑郁的对照研究[J]. 中国临床药理学与治疗学, 2011, 16(9): 1042-1046.

SHEN Zhong-xia, QIAN Ming-cai, SHEN Xing-hua, CHEN Hai-zhi, LIN Min. The control research of Bupropion combined with Lithium Carbonate in the treatment of bipolar depression[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(9): 1042-1046.

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