Bakish D, Ravindran A, Hooper C, Lapierre Y
Department of Psychiatry, University of Ottawa, Ontario, Canada.
Psychopharmacol Bull. 1994;30(1):53-9.
In spite of its significant morbidity, dysthymic disorder has been under-researched, therefore effective treatment options are limited. This article presents data suggesting that dysthymia can be treated effectively with psychopharmacologic agents. A double-blind, placebo-controlled 7-week drug trial comparing imipramine to ritanserin, a serontonin-2 antagonist, indicated that both drugs were significantly more effective than placebo in alleviating dysthymia symptoms. Imipramine was slightly more effective than ritanserin, as indicated by ratings on the Hamilton Depression Rating Scale and the Zerssen Self-Rating Scale; however, imipramine also produced more side effects. On the basis of this study, we continued an open protocol for treating dysthymic patients with a specific serotonin reuptake inhibitor, fluoxetine. This open-label study indicated that fluoxetine was successful in reducing the dysthymia symptoms, particularly in the subaffective sub-type. These studies confirm the need for further research into the treatment options for patients suffering from dysthymia.
尽管恶劣心境障碍发病率颇高，但相关研究却较少，因此有效的治疗方案有限。本文提供的数据表明，恶劣心境障碍可用精神药物有效治疗。一项为期7周的双盲、安慰剂对照药物试验，比较了丙咪嗪与5-羟色胺-2拮抗剂利坦色林，结果表明两种药物在缓解恶劣心境障碍症状方面均显著优于安慰剂。根据汉密尔顿抑郁量表和泽尔森自评量表的评分，丙咪嗪比利坦色林稍有效；然而，丙咪嗪产生的副作用也更多。基于这项研究，我们继续采用开放方案，用一种特定的5-羟色胺再摄取抑制剂氟西汀治疗恶劣心境障碍患者。这项开放标签研究表明，氟西汀成功减轻了恶劣心境障碍症状，尤其是在亚情感亚型中。这些研究证实有必要对恶劣心境障碍患者的治疗方案做进一步研究。
