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[帕罗西汀与阿米替林治疗经临床评估患有抑郁症的乳腺癌患者的有效性及耐受性的双盲对照研究]

[A double-blind comparative study of the effectiveness and tolerance of paroxetine and amitriptyline in treatment of breast cancer patients with clinically assessed depression].

作者信息

Möslinger-Gehmayr R, Zaninelli R, Contu A, Oberhoff C, Gutschow K, Schindler A E, Staab H J

机构信息

AKH Wien.

出版信息

Zentralbl Gynakol. 2000;122(4):195-202.

PMID:10795116
Abstract

OBJECTIVE

In this double-blind, non-placebo controlled study [corrected], 179 patients with treated breast cancer who fulfilled the ICD-10 criteria for an acute depressive episode underwent an 8-week course of antidepressant treatment with either the tricyclic amitriptyline (75-150 mg, n = 87) or the serotonin-reuptake inhibitor paroxetine (20-40 mg, n = 88).

METHODS

The change in clinical status relative to baseline was measured with the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impression (CGI), the Functional Living Index-Cancer (FLIC) and the Patient Global Evaluation.

RESULTS

Both treatment groups showed significant improvement in all parameters at weeks 3, 5 and 8. At no time was there a significant difference in the efficacy of the antidepressants used. Adverse events, most of which were transitory, were reported by 53% of the patients in the paroxetine group and 60% in the amitriptyline group. The 8-week treatment was completed by 81% of the paroxetine and 76% of the amitriptyline patients.

CONCLUSIONS

The results of this study show that depression in breast-cancer patients can be correctly diagnosed and adequately treated by non-psychiatrists. The treatment with both medications was carried out in dose ranges which correspond to that employed in physically well patients.

摘要

目的

在这项双盲、非安慰剂对照研究中,179名符合国际疾病分类第十版(ICD - 10)急性抑郁发作标准的乳腺癌患者接受了为期8周的抗抑郁治疗,治疗药物为三环类药物阿米替林(75 - 150毫克,n = 87)或5-羟色胺再摄取抑制剂帕罗西汀(20 - 40毫克,n = 88)。

方法

采用蒙哥马利 - 阿斯伯格抑郁评定量表(MADRS)、临床总体印象量表(CGI)、癌症功能生活指数(FLIC)和患者总体评估量表来衡量相对于基线的临床状态变化。

结果

两个治疗组在第3周、第5周和第8周时所有参数均有显著改善。所使用的抗抑郁药物疗效在任何时候均无显著差异。帕罗西汀组53%的患者和阿米替林组60%的患者报告了不良事件,其中大多数为短暂性。帕罗西汀组81%的患者和阿米替林组76%的患者完成了为期8周的治疗。

结论

本研究结果表明,非精神科医生能够正确诊断并充分治疗乳腺癌患者的抑郁症。两种药物的治疗剂量范围与身体健康患者所使用的剂量范围一致。

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