Fabre L F, Feighner J P
J Clin Psychiatry. 1983 Jan;44(1):17-21.
Trazodone and imipramine were compared in a two-center double-blind study of moderately to severely depressed outpatients. Results for 44 patients who have completed the 12-month comparison showed superior efficacy of trazodone at endpoint on all efficacy measures. Significant differences were also seen on individual Hamilton Depression Rating Scale items, with lower anxiety scores at 5 evaluation points for the trazodone group. Clinical Global Impressions ratings also favored trazodone treatment. Anticholinergic effects and tremor were significantly more frequent in imipramine-treated patients, whereas drowsiness was more frequent with trazodone. No significant changes were seen in blood pressure or ophthalmologic exams; 2 trazodone patients and 1 imipramine patient developed slight ECG changes during therapy; these may have been age-related. Continued clinical benefit has been seen in 12 patients who have received open-label trazodone for additional periods of up to 3 years. These findings show trazodone to be clearly effective in long-term treatment of moderate to severe depression; the drug may be of particular benefit when atropine side effects pose serious problems, as in the elderly and patients with cardiovascular disorders.
在一项针对中度至重度抑郁门诊患者的两中心双盲研究中，对曲唑酮和丙咪嗪进行了比较。44名完成了为期12个月比较的患者的结果显示，在所有疗效指标的终点，曲唑酮的疗效更佳。在汉密尔顿抑郁量表的个别项目上也观察到了显著差异，曲唑酮组在5个评估点的焦虑得分更低。临床总体印象评分也更倾向于曲唑酮治疗。丙咪嗪治疗的患者中，抗胆碱能效应和震颤明显更常见，而曲唑酮治疗的患者中嗜睡更常见。血压或眼科检查未见显著变化；2名曲唑酮治疗患者和1名丙咪嗪治疗患者在治疗期间出现轻微心电图改变；这些改变可能与年龄有关。12名接受开放标签曲唑酮治疗长达3年的患者持续显示出临床获益。这些发现表明，曲唑酮在中度至重度抑郁的长期治疗中明显有效；当阿托品样副作用带来严重问题时，如在老年人和心血管疾病患者中，该药可能特别有益。
