Davidson J, Kudler H, Smith R, Mahorney S L, Lipper S, Hammett E, Saunders W B, Cavenar J O
Duke University Medical Center, Durham, NC 27710.
Arch Gen Psychiatry. 1990 Mar;47(3):259-66. doi: 10.1001/archpsyc.1990.01810150059010.
Amitriptyline hydrochloride was compared with placebo in 46 veterans with chronic posttraumatic stress disorder. Treatment continued up to 8 weeks, and efficacy was measured by five observer and two self-rated scales. Percent recovery rates were higher for amitriptyline than placebo on two measures. In patients who completed 4 weeks (n = 40), better outcome with amitriptyline was noted on the Hamilton depression scale only. In the group completing 8 weeks of treatment (n = 33), the drug was superior to placebo on Hamilton depression, Hamilton anxiety, Clinical Global Impression severity, and Impact of Event scales. There was no evidence for drug effects on the structured interview for posttraumatic stress disorder. Drug-placebo differences were greater in the presence of comorbidity in general, although recovery rates were uniformly low in the presence of major depression, panic disorder, and alcoholism. At the end of treatment, 64% of the amitriptyline and 72% of the placebo samples still met diagnostic criteria for posttraumatic stress disorder.
将46名患有慢性创伤后应激障碍的退伍军人的盐酸阿米替林与安慰剂进行了比较。治疗持续长达8周，并通过五个观察者评定量表和两个自评量表来衡量疗效。在两项测量中，阿米替林的康复率百分比高于安慰剂。在完成4周治疗的患者（n = 40）中，仅在汉密尔顿抑郁量表上观察到阿米替林的治疗效果更好。在完成8周治疗的组（n = 33）中，该药物在汉密尔顿抑郁量表、汉密尔顿焦虑量表、临床总体印象严重程度量表和事件影响量表上优于安慰剂。没有证据表明药物对创伤后应激障碍的结构化访谈有影响。一般来说，在存在共病的情况下，药物与安慰剂的差异更大，尽管在存在重度抑郁症、惊恐障碍和酒精中毒的情况下康复率普遍较低。治疗结束时，64%的阿米替林样本和72%的安慰剂样本仍符合创伤后应激障碍的诊断标准。
