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題 名 | Fluvoxamine及Fluoxetine治療憂鬱症之單盲比較研究=A Single-Blind Trial of Fluvoxamine Versus Fluoxetine in Depressive Disorders |
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作 者 | 曾美智; 李宇宙; 李明濱; 王浩威; | 書刊名 | 臺灣精神醫學 |
卷 期 | 12:4 1998.12[民87.12] |
頁 次 | 頁36-46 |
分類號 | 418.214 |
關鍵詞 | 憂鬱症; Fluvoxamine; Fluoxetine; Depressive disorders; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:瞭解 fluvoxamine 在治療憂鬱症的效果,並比較 fluvoxamine 和 fluoxetine 的副作用與兩者在憂鬱症合併的焦慮症狀的效果。 方法:精神科門診或住院病 人,年齡 18 歲到 70 歲,臨床上有憂鬱合併明顯的焦慮症狀,依 DSM-IV 診斷包含重鬱症 、 輕鬱症和焦慮與憂鬱混合症的病人, 隨機分配於 fluvoxamine (50-200mg) 和 fluoxetine (20-60mg) 組,每組各有 29 名,進行單盲比較評估,治療期間一共八週。 療 效的評估係根據 17 題的漢氏憂鬱症狀量表、臨床整體嚴重度和改善量表以及簡式症狀量表 。結果:fluvoxamine 組有 20 位 (69%),fluoxetine 組有 19 位 (65.5%) 完成治療。依 HAM-D 的評估結果, fluvoxamine 組的治療反應率為 90% (N=18), fluoxetine 為 89.5% (N=17)。第一週時,就漢氏憂鬱症狀量表和及簡式症狀量表的憂鬱和一般嚴重度指標而言, 兩種藥均表現明顯療效,但 fluvoxamine 有較明顯的抗憂鬱作用。 研究結束時兩種藥對憂 鬱症狀的治療有同樣的效果。治療過程中,只有一位病人使用 fluoxetine 引發躁症退出研 究,症狀的類別、分佈和嚴重度上,兩種藥均沒有達顯著的差異,亦沒有病人因為無法忍受 副作用而中途退出治療。和國外研究比較,本研究中兩組病人抱怨口乾和沒力氣的比率偏高 ,在頭痛、厭食、噁心、失眠、激動和神經質的比率均偏低。漢氏憂鬱症狀量表及簡式症狀 量表焦慮相關的各症狀面向得分,隨著治療週數,呈現逐漸改善的趨勢;但在治療的每一階 段,兩組的治療效果並無顯著的差異。結論:fluvoxamine 和 fluoxetine 對憂鬱症和其合 併的焦慮症狀均同樣有效。 |
英文摘要 | Objective: To investigate the efficacy of fluvoxamine and fluoxetine in the treatment of depressive disorders and associated anxiety symptoms. Methods: The study subjects were depressive disorder patients with prominent anxiety symptoms, aged from 18 to 70 years old. They were randomly allocated to receive either fluvoxamine (50-200 mg, 29 persons) or fluoxetine (20-60 mg, 29 persons) for 8 weeks and were rated at pretreatment and in the 1st, 2nd, 4th, 6th, and 8th week of treatment by a psychiatrist who was blind to the medication regtimen. Efficacy was accessed with the 17-items HAM-D, the Clinical Global Impression of Severity and Improvement (CGIS and CGII), and BSRS. Adverse effects were assessed by the UKU Side Effect Rating Scale. Results: Sixty-nine percent of the patients in the fluvoxamine group and sixty-seven percent of the patients in the fluoxetine group completed the trial. The mean scores of the HAM-D in both groups at the end point were less than 10. The response rate (response defined as a decrease of 50% from the original score) was 90% in the fluvoxamine group and 89.5% in the fluoxetine group according to HAM-D scores. There were no statistically significant differences between the two groups on any efficacy parameter measured at the end of the treatment regimen. However, fluvoxamine was slightly more effective in reducing the HAM-D score and both the depression and the GSI subscale scores of the BSRS than fluoxetine during the first week of treatment. There were no differences in the side-effect profiles between the two groups. Both drugs were equally effective in reducing HAM-D scores for psychic anxiety and somatic anxiety, and in reducing scores on the anxiety subscale of the BSRS. Conclusion: Fluvoxamine and Fluoxetine had a similiar effectiveness in treating depressive patients. |
本系統中英文摘要資訊取自各篇刊載內容。