Panteleeva G P, Abramova L I, Korenev A N
Zh Nevrol Psikhiatr Im S S Korsakova. 2000;100(3):36-41.
In order to specify differential indications for the use of selective serotonin reuptake inhibitors (SSRI) their therapeutic effect was investigated in apathic-adynamic, melancholic and anxious depressions. Group of 151 patients received monotherapy with one of SSRI-drugs: citalopram--22 patients (mean daily dosage--27.4 mg), paroxetine--47 patients (23 mg), sertraline--19 patients (107 mg), fluvoxamine--28 patients (162 mg), fluoxetine--35 patients (20 mg). The state of the patients was estimated 5 times during 42 days of therapy by clinical estimations and according to Hamilton Depression Scale (HAM-D). Therapeutic effects of the drugs were determined according to the degree of reduction of the total HAM-D scores and they were considered as "significant" (a reduction of the scores by 50% and more), "moderate" (by 21-49%), and "insignificant" (by 1-20%). Positive antidepressive effect, including "significant" was obtained in the case of the use of all the drugs studied. Differential evaluation of the three components of antidepressive activity (thymoleptic, sedative-anxiolytic, and stimulative) according to the degrees and data of expression of drugs' therapeutic effect has allowed to determine indications for the therapy of endogenous depressions by each of SSRI: to recommend cytalopram for the treatment of various types of depressive states mainly, for anxious and apatho-adynamic types; paroxetin--for treatment of melancholic depressions as well as for anxious and apatho-dynamic ones; sertralin++--for depression with anxiety and fobic disorders; fluvoxamine--for melancholic and anxious depression; fluoxetine--for apatho-adynamic depressions.
为明确选择性5-羟色胺再摄取抑制剂（SSRI）的不同适应证，对其在无情感动力型、抑郁型和焦虑型抑郁症中的治疗效果进行了研究。151例患者接受了其中一种SSRI药物的单一疗法：西酞普兰——22例患者（平均日剂量——27.4毫克），帕罗西汀——47例患者（23毫克），舍曲林——19例患者（107毫克），氟伏沙明——28例患者（162毫克），氟西汀——35例患者（20毫克）。在治疗的42天内，通过临床评估并根据汉密尔顿抑郁量表（HAM-D）对患者状态进行了5次评估。根据HAM-D总分的降低程度确定药物的治疗效果，分为“显著”（分数降低50%及以上）、“中度”（降低21%-49%）和“不显著”（降低1%-20%）。使用所有研究药物均获得了包括“显著”在内的积极抗抑郁效果。根据药物治疗效果的程度和数据，对抗抑郁活性的三个组成部分（心境稳定、镇静抗焦虑和刺激）进行差异评估，从而确定每种SSRI治疗内源性抑郁症的适应证：建议主要使用西酞普兰治疗各种类型的抑郁状态，尤其是焦虑型和无情感动力型；帕罗西汀——用于治疗抑郁型抑郁症以及焦虑型和无情感动力型抑郁症；舍曲林——用于治疗伴有焦虑和恐惧障碍的抑郁症；氟伏沙明——用于治疗抑郁型和焦虑型抑郁症；氟西汀——用于治疗无情感动力型抑郁症。
