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中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (11): 1263-1267.

• 药物治疗学 • 上一篇    下一篇

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

沈仲夏1,2,沈鑫华2,蔡敏2,方瑜2,林敏2,杨剑虹2,许毅3   

  1. 1 浙江大学医学院,杭州 310058,浙江; 2 湖州市第三人民医院, 湖州 313000, 浙江; 3 浙江大学附属第一医院精神科,杭州 310009,浙江
  • 收稿日期:2013-12-05 修回日期:2014-09-09 出版日期:2014-11-26 发布日期:2014-12-09
  • 通讯作者: 许毅,博导,主要从事心身医学的研究。Tel:13805746579 E-mail:xuyizju@163.com
  • 作者简介:沈仲夏,男,在读硕士,主要从事心身医学的临床治疗及发病机制 的研究。Tel:13867291596 E-mail:snowszx@sina.com
  • 基金资助:
    浙江省公益技术运用研究项目(2012C33006)

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

SHEN Zhong⁃xia1,2, SHEN Xing⁃hua2,CAI Min2,FANG Yu2,LIN Min2, YANG Jian⁃hong2, XU Yi3   

  1. 1 Zhejiang University School of Medicine,Hangzhou 310058 Zhejiang,China;
    2 The Third People's Hospital of Huzhou City, Huzhou 313000,Zhejiang, China;
    3 Department of psychiatric, the First Affiliated Hospitol of Zhejiang University School of Medicine, Hangzhou 310009,Zhejiang, China
  • Received:2013-12-05 Revised:2014-09-09 Online:2014-11-26 Published:2014-12-09

摘要: 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 20 mg/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 20 mg/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。

关键词: 艾司西酞普兰, 快速滴定, 广泛性焦虑障碍, 广泛性焦虑量表?7

Abstract: AIM: To explore wether fast up?titration of escitalopram can make patients with generalized anxiety disorder (GAD) response quicker and elevate the efficacy by the end of the 8th 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 8 weeks. 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?7 scores in fast up?titration 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 were 11.1%,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 was 2.4%,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.

Key words: escitalopram, fast up?titration, generalized anxiety disorder, GAD?7

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