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

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• 英文论文题名：The control research of fast up-titration of Escitalopram in the treatment of Generalized Anxiety Disorder(GAD)
• 论文作者：沈仲夏 ; 沈鑫华 ; 蔡敏 ; 方瑜 ; 林敏 ; 杨剑虹 ; 许毅
• 英文论文作者：Shen Zhongxia ; Shen Xinghua ; Cai Min ; Fang Yu ; Lin Min ; Yang Jianhong ; Xu Yi ; Zhejiang University School of Medicine ; the Third People's Hospital of Huzhou City ; The first affiliated hospital Zhejiang University School of Medicine
• 年：2014
• 作者机构：浙江大学医学院;湖州市第三人民医院心身科;浙江大学附属第一医院精神卫生科;
• 论文关键词：艾司西酞普兰 ; 快速滴定 ; 广泛性焦虑障碍 ; GAD-7
• 英文论文关键词：Escitalopram ; fast up-titration ; Generalized Anxiety Disorder ; GAD-7
• 会议召开时间：2014-11-20
• 会议录名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会论文汇编
• 语种：中文
• 分类号：R749.72
• 学会代码：ZJKX
• 会议名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会
• 会议地点：中国浙江湖州
• 主办单位：浙江省医学会精神病学分会（The Society of Psychiatry ; ZJMA）、浙江省医师协会精神科医师分会
• 学会名称：浙江省科学技术协会
• 页数：4
• 文件大小：424k
• 原文格式：O
• 会议级别：地方

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20mg/日)(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20mg/日)(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%,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%,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显著性。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。
Objective:To explore weather fast up-titration of escitalopram can make GAD patients response quicker and elevate the efficacy by the end of the 8 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,I~(st),2~(th),4~(th),8~(th) 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 1~(st),2~(th),4~(th),8~(th) week(P<0.05) respectively.The remission rate of fast up-titration group is 11.1%,27.8%,50%,72.2%,and response rate is 33.3%,50%,63.9%,88.9%,while the remission rate of normal up-titration group is 2.4%,11.9%,38.4%,50.0%,and response rate is 11.9%,28.6%,42.9%,66.7%at the end of 1~(st),2~(th),4~(th),8~(th) weekend.The whole efficacy of fast up-titration group is better than normal up-titration group(P<0.05).The side effects of both groups have 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.

引文

1.Kessler RC,Berglund P,Demler O,et al.Lifetime prevalence and age-of-onset distributions of DSM-Ⅳdisorders in the National Comorbidity Survey Replication[J].Arch Gen Psychiatry 62:593-602.
    2.Phillips M R,Zhang J,Shi Q,et al.Prevalence,treatment,and associated disability of mental disorders in four provinces in China during 2001-05:an epidemiological survey[J].Lancet,2009,373(9680):2041-2053.
    3.Hoffman DL,Dukes EM,WittchenHU.Human and economic burden of generalized anxiety disorder[J].Depress Anxiety,2008,25(1):72-90.
    4.JR Davidson,W Zhang,KM Connor,et al,A psychopharmacological treatment algorithm for generalised anxiety disorder(GAD).[J]Journal of Psychopharmacology(2008)10(2):1-24
    5.Stahl SM.Stahl's essential psychopharmacology neuroscientic basis and practical application.3rd edt[M]//New York:Cambridge University Press,2008:767.
    6.Bereza B G,Machado M,Ravindran A V,et al.Evidence-based review of clinical outcomes of guideline-recommended pharmacotherapies for generalized anxiety disorder[J].Can J Psychiatry,2012,57(8):470—478.
    7.Davideson JR,Bose A,Kozotzer A,et al,.Escitalopram in the treatment of generalized anxiety disorder:Double-blind,placebo controlled,flexible-dose study[J].Depress Anxiety,2004,19(4):234-240
    8.沈仲夏,关铁峰,沈鑫华等,艾司西酞普兰与文拉法辛缓释剂治疗广泛性焦虑障碍的对照研究[J]。中国临床药理学与治疗学,2012,17(10):1167-1170.
    9.何筱衍,李春波,钱洁等,广泛性焦虑量表在综合性医院的信度和效度研究[J]。匕海精神医学,2010,22(04):200-203
    10.Spitzer RL,Kroenke K,Williams JBW,et al A brief measure for assessing generalized anxiety disorder:the GAD—7[J].Arch Intern Med,2006,166:1092-1097.
    11.吴文源.焦虑障碍防治指南[M].北京:人民卫生出版社,2010:25.
    12.Anjana Bose,Andrew Korotzer,Carl Gommoll,et al,Randomized placebo-controlled trial of escitalopram and venlafaxine XR in the treatment of generalized anxiety disorder[J].Depress and Anxiety.2008(25)10:854-61
    13.司天梅,黄继忠,于欣,Stahl精神药理学精要(神经科学基础与临床应用)(第3版)[J]//北京:北京大学医学出版社,2011:454-455
    14.司天梅,黄继忠,于欣,Stahl精神药理学精要(神经科学基础与临床应用)(第3版)[J]//北京:北京大学医学出版社,2011:467-468
    15.Goodman WK,Bose A,Wang Q,et al.Treatment of generalized anxiety disorder with escitalopram:Pooled results from double-blind,placebo-controlled trials[J].Journal of Affective Disorder,2005,87(2-3):161-167.
    16.Montgomery SA,Sheehan DV,Meoni P,et al.Characterization of the longitudinal course of improvement in generalized anxiety disorder during long-term treatment with venlafaxine XR[J].J Psychiatr Res,2002,36(4):209-217。