Improvement of sleep and anxiety in patients of major depression with fluoxetine combined with small dose of olanzapine

Wei QU; Yuanyuan QIN

ABSTRACT

BACKGROUND:

Major depression is a subtype of depression. Application of thymoleptics alone has bad effect. It has shown from relevant studies abroad that application of fluoxetine combined with atypical antipsychotic drugs maybe an effective treating strategy.

OBJECTIVE:

To observe the curative effects of fluoxetine combined with olanzapine and the time of its taking effect.

DESIGN:

Comparative study of open clinical test with completely random sampling for the first visit outpatients

SETTING:

A psychological consulting clinic in a hospital of a Military Medical College of Chinese PLA.

PARTICIPANTS:

Totally 140 patients visiting psychological counseling outpatient clinic in the hospital were collected from January 2004 to August 2004. Inclusion criteria According to the diagnostic criterion of depression of CCMD-3, patients with total scores of 17 items in Hamilton depression rating scale≥28and age ≥18 years old .EXclusion criteria;①slight to middle edgree of depression(Hamt≤27);②secondary depression;③convalesscent period of schizophrenia and other affective disorder caused by psychosis;④severe of unstable body diseases ,including diseases of liver,kidney,cardiae vessel,respiration,gastro-intestine,endocrine,nervous system,innune system or hematological system,cet.⑤drug or alcohol addict;⑥women in pregnancy and lactation. Totally 110 patients accorded with the inclusive criteria. Among them, there were 40 males and 70 females with the course of disease for 4 months to 5 years, aged 18 to 63 with the average (37 ± 12) years old. They all took part in the trial voluntarily. According to the date of admittance, they were divided into odd-numbered date alprazolam group in which there were 55 patients with 21 males and 34 females and double date olanzapine group in which there were 55 patients with 19 males and 36 females.

METHODS:

The patients were divided into 2 groups according to the date of admittance. Odd-numbered date group was alprazolam group. 0.4 mg alprazolam was given every noon and before sleep and 20 mg fluoxetine was given at a draught after breakfast every day. Even-numbered date group was olanzapine group. 2.5 mg olanzapine was given before sleep every day and 20mg fluoxetine was given at a draught after breakfast every day. The course of treatment was 6 weeks. HAMD and HAMA scores of taken were evaluated respectively before and at the end of 1st, 2nd, 4th and 6th week. Reducing score rate was used to decide effective time. Lost rate was presented as percentage. And improvement of sleep factor and somatization factor in HAMD were observed before therapy and at every observing time period after therapy.MAIN OUTCOME

MEASURES:

Terminus index Comparison of HAMD,HAMA score in the two groups before therapy and at the 1st, 2nd, 4th and 6th weekend after therapy. Scores of sleep factor and anxiety somatization factor of HAMD at every observing time period in the two groups. Substitution index lost rate in the two groups. Reducing score rate at every observing time period in the two groups.

RESULTS:

Lost rate in olanzapine group was significantly lower than that in alprazolam group ( P ＜ 0.05) and the effect was taken at 1 week after therapy(excellence rate 67% ) . But, scores of HAMD and HAMA at every observing time period in olanzapine group were significant lower than those in alprazolam group( P ＜ 0.01) and sleep factor and somatization factor at every observing time period improved more significantly than those of alprazolam group( P ＜ 0. 01).

CONCLUSION:

Small amount of olanzapine combined with fluoxetine used to treat major depression of the patients can improve sleep and anxiety body symptoms rapidly and then elevate their living quality significantly.