药物与临床
ZHU Yi-ping
2008, 27(4): 408-411.
Objective To compare the efficiency and side effects of mirtazapine and amitriptyline on treating depression accompanied with chronic pain. Methods 68 out-patients consistent with the diagnostic criteria of depression and chronic pain simultaneously were divided into the treatment group with 36 and control group with 32. Patients were treated with amitriptyline at the range of 0.2-0.8 mg8226;d-1. The treatment group was added with mirtazapine 15 mg, 30 mg,or to 45 mg if necessary, respectively once in the supper. The control group was added with amitriptyline 50,100 and 150 mg at the first, fourth and seventh day, respectively, during lunch and supper. HAMD,HAMA,TESS,VAS were assessed before treating and 7, 14, 28 days after treating. Results No significant difference of HAMD,HAMA,VAS existed between two groups before treatment. After 7 days’ treatment, the score of HAMD,HAMA,VAS in the treating group decreased rapidly, the significant difference was found(P<0.01)compared with those before treating(P<0.01). And the score was obviously lower than the control group(P<0.05,P<0.01). After treating for 28 days, scores of HAMD,HAMA,VAS of both groups were significantly different from those before treatment(P<0.01). But scores of HAMD,HAMA,VAS between two groups showed no difference(P>0.05). The difference of efficiency between two groups was not obvious(P>0.05). The total score of TESS in the treatment group was different or significantly different from that in the control group(P<0.05,P<0.01). Conclusion Mirtazapine could treat depression accompanied with chronic pain. It not only relieves the symptoms of depression and anxiety, but also improves or eliminates the symptoms of pain with relatively mild side effects.