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首页> 外文期刊>The journal of clinical psychiatry >Combined treatment with venlafaxine and tricyclic antidepressants in depressed patients who had partial response to clomipramine or imipramine: initial findings.
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Combined treatment with venlafaxine and tricyclic antidepressants in depressed patients who had partial response to clomipramine or imipramine: initial findings.

机译：在对氯米帕明或丙咪嗪部分反应的抑郁症患者中，联合使用文拉法辛和三环抗抑郁药进行联合治疗：初步发现。

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BACKGROUND: We report, after 3 years of work, a case series showing our initial results (efficacy, tolerability, and safety) with the addition of venlafaxine immediate release (IR) to either clomipramine or imipramine in depressed patients who had shown only partial response to maximal doses of one of those tricyclic antidepressants (TCAs) and no further improvement after addition of usual augmentation drugs. METHOD: Eleven patients were treated, 10 of them having a recurrent depressive disorder (DSM-IV) and all of them having current major depression (DSM-IV) that in 9 patients was moderate or severe despite intense TCA treatment as well as usual augmentations. Under open and outpatient conditions, we maintained TCA doses, discontinued previous augmentations, and then added venlafaxine IR to a maximum dosage, if necessary, of 150 mg every 12 hours. There was no control group. Response was assessed using the 17-item Hamilton Rating Scale for Depression (HAM-D), DSM-IV criteria, the Clinical Global Impressions-Severity of Illness scale, and persistence of improvements after 6 months. We measured clinical tolerance (using the UKU Side Effect Rating Scale), blood pressure and heart rate, electrocardiogram (ECG), and blood TCA levels after adding venlafaxine IR. RESULTS: A sustained improvement (> 50% decrease in HAM-D score plus decrease in DSM-IV severity level) appeared in 9 patients, and sustained full remission (DSM-IV criteria plus HAM-D score < 5) in 7. Panic-agoraphobic symptoms improved in the 2 patients suffering from them. There were no dropouts, and tolerability was good. No significant changes in blood pressure and heart rate, ECG, or blood tricyclic levels were found. CONCLUSION: Addition of venlafaxine to clomipramine or imipramine could be an effective and safe augmentation strategy in depressive patients with partial response to maximum-dose monotherapy. A consistent replication of these initial findings is strongly needed.
机译：背景：我们报告了经过3年的工作，一个病例系列显示了我们的初步结果（疗效，耐受性和安全性），并向仅显示部分缓解的抑郁症患者在氯米帕明或丙米嗪中添加了文拉法辛立即释放（IR）最大剂量的那些三环抗抑郁药（TCA）中的一种，并且在添加常用的增强药物后没有进一步的改善。方法：治疗了11例患者，其中10例患有复发性抑郁症（DSM-IV），所有患者均患有当前的重度抑郁症（DSM-IV），尽管进行了强力的TCA治疗和常规的强化治疗，其中9例患者为中度或重度。在开放和门诊条件下，我们维持TCA剂量，停止先前的增强治疗，然后在必要时每12小时加入文拉法辛IR至最大剂量150 mg。没有对照组。使用17个项目的汉密尔顿抑郁量表（HAM-D），DSM-IV标准，临床总体印象-疾病严重程度量表和6个月后改善的持续性来评估反应。加入文拉法辛IR后，我们测量了临床耐受性（使用UKU副作用评定量表），血压和心率，心电图（ECG）和血液TCA水平。结果：9例患者出现持续改善（HAM-D评分降低50％以上，DSM-IV严重程度降低），7例患者持续完全缓解（DSM-IV标准加HAM-D评分<5）。 2名患者的厌食症症状得到改善。没有辍学，并且耐受性良好。没有发现血压和心率，ECG或血液三环水平有明显变化。结论：在对最大剂量单药治疗有部分反应的抑郁症患者中，将文拉法辛与氯米帕明或丙咪嗪合用可能是一种安全有效的增强策略。强烈需要这些最初发现的一致复制。

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