Hochstrasser B, Isaksen P M, Koponen H, Lauritzen L, Mahnert F A, Rouillon F, Wade A G, Andersen M, Pedersen S F, Swart J C, Nil R
Privatklinik, CH-3860 Meiringen, Switzerland.
Br J Psychiatry. 2001 Apr;178:304-10. doi: 10.1192/bjp.178.4.304.
Major depression is highly recurrent. Antidepressant maintenance treatment has proven efficacy against recurrent depression.
Comparison of prophylactic efficacy of citalopram versus placebo in unipolar, recurrent depression.
Patients 18-65 years of age with recurrent unipolar major depression (DSM-IV), a Montgomery-Asberg Depression Rating Scale score of > or =22 and two or more previous depressive episodes, one within the past 5 years, were treated openly with citalopram (20-60 mg) for 6-9 weeks and, if responding, continued for 16 weeks before being randomised to double-blind maintenance treatment with citalopram or placebo for 48-77 weeks.
A total of 427 patients entered acute treatment and 269 were randomised to double-blind treatment. Time to recurrence was longer in patients taking citalopram than in patients taking placebo (P:<0.001). Prophylactic treatment was well tolerated.
Citalopram (20, 40 and 60 mg) is effective in the prevention of depressive recurrences. Patients at risk should continue maintenance treatment at the dose necessary to resolve symptoms in the acute treatment phase.
重度抑郁症极易复发。抗抑郁维持治疗已被证明对复发性抑郁症有效。
比较西酞普兰与安慰剂在单相复发性抑郁症中的预防效果。
年龄在18至65岁之间、患有复发性单相重度抑郁症（DSM-IV）、蒙哥马利-阿斯伯格抑郁评定量表评分≥22分且有两次或更多次既往抑郁发作（其中一次在过去5年内）的患者，先接受西酞普兰（20 - 60毫克）开放治疗6至9周，若有反应则继续治疗16周，之后随机接受西酞普兰或安慰剂双盲维持治疗48至77周。
共有427名患者进入急性治疗阶段，269名患者被随机分配至双盲治疗组。服用西酞普兰的患者复发时间比服用安慰剂的患者更长（P < 0.001）。预防性治疗耐受性良好。
西酞普兰（20毫克、40毫克和60毫克）在预防抑郁复发方面有效。有风险的患者应在急性治疗阶段使用能缓解症状的剂量继续进行维持治疗。
