Brown W A, Harrison W
Brown University School of Medicine, Providence, R.I.
J Clin Psychiatry. 1995 Jan;56(1):30-4.
The question was asked whether patients who discontinue one serotonin selective reuptake inhibitor (SSRI) because of side effects can be treated successfully with another SSRI.
113 patients with major depression who had discontinued fluoxetine because of side effects were enrolled in an open, multicenter, 8-week study designed to evaluate the tolerability and efficacy of sertraline. After a washout period of at least 3 weeks following fluoxetine discontinuation and an additional 1-week, single-blind, placebo washout period, patients began treatment with 50 mg of sertraline once daily. Doses were titrated upward as necessary to a maximum daily dose of 200 mg. Depressive symptoms and adverse events were evaluated weekly.
Based on the Clinical Global Impressions Scale, 79 (71.8%) of 110 patients evaluated for efficacy were "much" or "very much" improved relative to baseline. Only 11 (9.8%) of 112 patients discontinued sertraline because of adverse reactions.
These results suggest that patients who discontinue one SSRI because of side effects can be treated successfully with another.
有人提出这样一个问题，即因副作用而停用一种5-羟色胺再摄取抑制剂（SSRI）的患者，使用另一种SSRI进行治疗是否能够成功。
113名因副作用而停用氟西汀的重度抑郁症患者参与了一项开放、多中心、为期8周的研究，该研究旨在评估舍曲林的耐受性和疗效。在停用氟西汀后至少经过3周的洗脱期以及额外1周的单盲安慰剂洗脱期后，患者开始接受每日一次50毫克舍曲林的治疗。必要时将剂量上调至最大每日剂量200毫克。每周对抑郁症状和不良事件进行评估。
根据临床总体印象量表，在110名接受疗效评估的患者中，79名（71.8%）相对于基线有“明显”或“非常明显”的改善。在112名患者中，只有11名（9.8%）因不良反应而停用舍曲林。
这些结果表明，因副作用而停用一种SSRI的患者可以成功地用另一种SSRI进行治疗。
