69 54-57. 9. Bromet E Dew MA. Review of psychiatric epidemiolonic research on disasters. Epidemion Rev. 995 7 3-9. 0. Pvnoos RS Goenjian A Tashjian M et al. Post - traumat-. Galea S Nandi A Vlahov D. The epidemiology of post - ic stress reaction in children after 988 Aimenian earthquake traumatic stress disorder after disasters. Epidemiol Rev. in Amenia. Br J Psychiatry 993 63 239-47. 2005 27 78-9.. 7 2. PTSD 200 5 3 2003 24 4 487-489. 45-47. 3. 2. 2000 4 7-2008 6 89-9. 9. 4. 3. 998 2 3 36. 994 2 2 09-5. 2 3. 2008 46-447. 4. Martorell A Tsakanikos E Pereda A et al. Mental health 6. 2 2006 6-62 63. 7. Jones E Vermaas RH McCartney H et al. Flashbacks and post - traumatic stress disorder the genesis of a 20th - century in adults with mild and moderate intellectual disabilities the role of recent life events and traumatic experiences across the life span. J Nerv Ment Dis. 2009 97 3 82-86. diagnosis. Br J Psychiatry 2003 82 2 58-63. 8. Catherine So - kum. Trajectory of traumatic stress symptoms in the aftermath of extreme natural disaster A study of adult Thai survivors of the 2004 southeast Asian earthquake and tsunami. Journal of Nervous & Mental Disease 2007 95 5. Grinde B. Can the concept of discords help us find the causes of mental diseases Medical Hypotheses 2009 73 06-09. 6. 2009 8 3 20-203. 20 4 3 3 4 2 5 6 7 8 6 CCMD - 3 HAMD 7 HAMA 4 73 0mg - 20mg /d 2 4 6 7 HAMD HAMA CGI CGI - SI CGI - GI 69 6 HAMD HAMA CGI - SI HAMD - 7 HAMA. 400 2. 3. 4. 5. 6. 7. 8. 985 Email llyyz2006@ 26. com
70 39 2 202 CGI - SI P < 0. 05 8. % 63. 9% 0. 06% R749. 053 A 673-2952 202 02-0069 - 05 Efficacy of Escitalopram in the treatment of major depressive disorders with anxiety symptoms. WU Haishan CHANG Maihui LI Lehua et al. Mental Health Institute the Second Xiangya Hospital Central South University Changsha 400 China. Abstract Objective The objective of this study was to assess the efficacy and tolerability of escitalopram 0 to 20 mg /d for treating the patients of major depressive disorders with anxiety. Methods This is an open - label multicentre flexible - dose 0 ~ 20 mg /d and 6 weeks treatment clinical trial. Outpatients and inpatients were enrolled to accept escitalopram treatment for 6 weeks if they met with the CCMD - 3 criteria of depressive episode and had a baseline Hamilton Rating Scale for Depression HAMD score of 7 and a Hamilton Rating Scale for Anxiety HAMA score of 4. The efficacy was assessed with HAMD HAMA and CGI at the end of baseline and 2 4 6 weeks after treatment while safety was estimated with adverse event rating scale laboratory and physical examination. Results The HAMD scores HAMA scores and CGI - SI scores had significant reduction during 6 weeks escitalopram treatment. The response rate and remission rate were 8. % and 63. 9% respectively. The adverse drug reactions such as nausea and other gastrointestinal discomfort were tolerated. Conclusion Escitalopram has positive effectiveness in major depressive with anxiety disorders. Key words Depression Anxiety Escitalopram Efficacy MDD CCMD - Ⅲ 3 8 ~ 65 4 5 SSRIs HAMD 7 7 SSRIs HAMA 4 6 SSRIs S - 5 2 - HT SSRIs 3 α 2 4 5 6 7 8 9 2009 0 ~ 200 09 > 25% 4 2 2 0 30 2 HAMD - 7 3 Ⅳ
7 3 6 P < 0. 05 0mg 3 H20080788 3. 0mg /d 73 69 79 45. 3% 90 54. 7% 37. 6 ± 2. 7 HAMD 25. 04 HAMD < 50% 5 ~ ± 0. 38 HAMA 20. 74 ± 0. 4 20mg /d CGI - SI 4. 63 ± 0. 9 3. 2 3. 2. HAMD 4 HAMD HAMD 2 4 6 HAMD 2 7. 34 ± 2. HAMD P 2.. < 0. 00 HAMD HAMD 2 4 6 HAMD HAMA HAMD P < 0. 00 / 2 4 6 HAMD / CGI SI 0-3 5 7 HAMD / GI 2.. 2 HAMD P < = - / 0. 00 00% 7 50% 8. % 63. 9% 0. 54 % 69. 25 ± 26. 05 3. 2. 2 HAMA 2.. 3 HAMA HAMA 2 4 6 HAMA 4. 73 ± 6 0. 43 % 7. 02 ± 24. 07 RBC WBC Hb PLT HAMA P U - Glu UPro U - RBC U - WBC < 0. 00 HAMA ALT AST Cr BUN HAMA 2. 2 HAMA SPSS7. 0 x 珋 ± SD P < 0. 00 2 Wilcoxon
72 39 2 202 HAMD week 2week 4week 6week HAMD SD 25. 04 ± 0. 38 2. 3 ± 0. 40 6. 7 ± 0. 43. 54 ± 0. 43 7. 70 ± 0. 45 HAMD - SD 2. 87 ± 0. 69 2. 48 ± 0. 78. 95 ± 0. 76. 45 ± 0. 70 0. 93 ± 0. 80 HAMD / - 0-3 5 7 SD 7. 78 ± 2. 09 6. 84 ± 2. 07 5. 56 ±. 92 4. 02 ± 2. 0 2. 83 ± 2. 24 P 0. 000 * 0. 000 * 0. 000 * 0. 000 * * HAMD - 7 P < 0. 00 2 HAMA week 2week 4week 6week HAMA SD 20. 74 ± 0. 4 7. 35 ± 0. 4 3. 59 ± 0. 38 9. 39 ± 0. 4 6. 0 ± 0. 42 HAMA - SD. 93 ± 0. 77. 66 ± 0. 72. 4 ±. 2. 2 ±. 80 0. 68 ± 0. 69 HAMA - - 6 4 SD 2. 93 ± 3. 0 0. 99 ± 2. 90 8. 8 ± 3. 5 6. 34 ± 3. 77 4. 4 ± 3. 24 HAMA - 7-3 SD 7. 93 ± 3. 6. 47 ± 2. 64 4. 97 ± 2. 52 3. 5 ± 2. 29. 95 ± 2. 32 P 0. 000 * 0. 000 * 0. 000 * 0. 000 * * HAMA P < 0. 00 3. 2. 3 CGI NEβ 2 4 6 CGI CGI - SI 4. 63 ± 0. 9 4. 32 ± 0. 90 3. 66 ± 0. 93 3. 0 ± 0. 97 2. 24 ±. 5 CGI - GI CGI - SI P < 0. 05 3. 3 P > 0. 05 7 0. 06% 5 3 2 2 2 7 ~ 2 5 6 4 50% Zimmerman 57. 49% 3 8 9 SSRIs 5 - HT β 5 - HT 5 - HT 4 5 - HT 5-5 - HT NE HT
73 5 - HT 4. β β2 5 - HT 5-2006 28 2 50 - HT 0 5. 5. De Nayer A Geerts S Ruelens L et al. Venlafaxine compared with fluoxetine in outpatients with depression and con- 5 - HT 5 - HT comitant anxiety. Int J Neuropsychopharmacol. 2002 5 2 5-20. 6. Dunner DL Goldstein DJ Mallinckrodt C et al. Duloxetine in treatment of anxiety symptoms associated with depression. HAMD HAMA CGI - S Depress Anxiety 2003 8 2 53-6. 6 7. Belzer K Schneier FR. Comorbidity of anxiety and depressive disorder Issues in conceptualization assessment and treatment. J Psychiatr Pract. 2004 0 5 296-306. 8. Pollack MH. Optimizing pharmacotherapy of generalized anxiety disorder to achieve remission. J Clin Psychiatry 200 62 20-25. PD 9. Blanco C Antia SX Liebowitz MR. Pharmacotherapy of social anxiety disorder. Biol Psychiatry 2002 5 09 - GAD 20. 0. Benfield PN. Citalopram A review of its pharmacology clinical efficacy and toterability in the treatment of depression. 2 3 GAD CNS Drugs 997 8 5 40-43. 20mg /d. Stahl SM Gergel I Li D. Escitalopram in the treatment of 40mg /d 4 panic disorder A randomized double - blind placebo - 327. 2. Goodman WK Bose A Wang Q. Treatment of generalized anxiety disorder with escitalopram Pooled results from doubleblind placebo - controlled trials. J Affect Disord. 2005. Nutt D. Management of patients with depression associated with anxiety symptoms. Clin Psychiatry 997 58 supp. 8-6. 2. Owens MJ Knight DL Nemeroff CB. Second - generation SS- RIs human monoamine transporter binding profile of escitalopram and R - fluoxetine. Biol Psychiatry 200 50 5 345-350. 3. Mmerman M. Frequency of anxiety disorders in psychiatric outpatients with major depressive disorder. Am J Psychiatry 2000 57 8 337-40. controlled trial. J Clin Psychiatry 2003 64 322-87 2-3 6-67. 3. Kasper S Stein DJ Loft H et al. Escitalopram in the treatment of social anxiety disorder randomised placebo - controlled flexible - dosage study. Br J Psychiatry 2005 86 3 222-226. 4. Chauvet - Gelinier JC. Efficacy of escitalopram vs paroxetine on severe depression with associated anxiety data from the " Boulenger" study. Encephale 200 36 5 425-432. 20 4 25