Klieser E, Lehmann E
Psychiatry Division, University of Duesseldorf, F.R.G.
Clin Neuropharmacol. 1989;12 Suppl 1:S18-24. doi: 10.1097/00002826-198901001-00004.
To establish the differential indication of trazodone and to find the predictors of its efficacy, we conducted a study in which 45 patients with major depressive disorder and 75 patients with acute schizophrenia were randomly assigned under double-blind conditions to either 400 mg trazodone daily, 150 mg amitriptyline daily, 20 mg haloperidol daily, or placebo daily. At the beginning of the investigations, numerous variables (basic data, MMPI, AMDP, HAM-A, HAM-D) were documented and evaluated on days 3, 7, 14, and 21. In our study, trazodone proved to be as effective an antidepressant drug as amitriptyline. In group comparison, no antipsychotic action of trazodone in schizophrenic patients could be proved. Yet the trazodone treatment was clearly of less risk than the amitriptyline treatment. Under trazodone, provocation of schizophrenic symptoms, which occurred numerously under amitriptyline, was found only in one patient out of 17 schizophrenics. Related to anamnesis and characteristics of the schizophrenic patient, a predictor-variable concerning the antipsychotic effect was not found. It can be assured, however, that patients with depressive symptoms (regarding the entity classification) respond to trazodone. After only 7 days of trazodone treatment, a relatively reliable decision can be established as to whether a therapeutical success can be expected if treatment is continued.
为确定曲唑酮的差异适应症并找出其疗效的预测因素,我们开展了一项研究,将45例重度抑郁症患者和75例急性精神分裂症患者在双盲条件下随机分配,分别给予每日400毫克曲唑酮、每日150毫克阿米替林、每日20毫克氟哌啶醇或每日安慰剂。在研究开始时,记录了众多变量(基础数据、明尼苏达多项人格调查表、AMDP、汉密尔顿焦虑量表、汉密尔顿抑郁量表),并在第3、7、14和21天进行评估。在我们的研究中,曲唑酮被证明是一种与阿米替林效果相当的抗抑郁药物。在组间比较中,未证实曲唑酮对精神分裂症患者有抗精神病作用。然而,曲唑酮治疗的风险明显低于阿米替林治疗。在曲唑酮治疗下,在阿米替林治疗时大量出现的精神分裂症症状激发情况,在17例精神分裂症患者中仅在1例患者身上发现。与精神分裂症患者的既往病史和特征相关,未发现与抗精神病效果有关的预测变量。然而,可以确定的是,有抑郁症状的患者(就疾病分类而言)对曲唑酮有反应。在曲唑酮治疗仅7天后,就可以相对可靠地确定如果继续治疗是否有望取得治疗成功。