Objective To compare the acute effect of intravenous injecting chlorimipramine, modified electroconvulsive therapy (MECT) and oral mirtazapine for suicidal idea of depression. Methods A total of 180 depressive patients were randomly divided into chlorimipramine group (60 cases) treated with intravenous injecting chlorimipramine, MECT group (60 cases) treated with MECT and mirtazapine group (60 cases) treated with oral mirtazapine. All patients were assessed with Hamilton Depression Scale ( HAMD) and Beck Scale for Suicide Ideation (BSI) at the baseline and the 3rd, 5th, 7th, 9th, 11th, 14th, 21th day of the treatment. Results Compared with baseline, scores of BSI showed significant decrease from the 3rd day in chlorimipramine group and MECT group (P < 0. 05 ) , while from the 7th day in mirtazapine group ( P < 0.05 ) . The decrease of score of BSI in chlorimipramine group and MECT group were significantly higher than that in mirtazapine group ( P < 0. 05 ). The remission rate of suicidal idea in chlorimipramine group was significantly higher than that in mirtazapine group from the 5th day (P <0.05) , and in MECT group from the 3rd day (P <0. 05). At the 7th day of the treatment, the remission rate of suicidal idea was 66.67% in chlorimipramine group and 70.90% in MECT group, while only 14.29% in mirtazapine group. ConclusionrnIntravenous injecting chlorimipramine is equivalent to MECT in its acute effect on suicidal idea of depression.%目的 比较氯丙咪嗪静滴、无抽搐电休克治疗(MECT)及米氮平口服在改善抑郁症患者的自杀观念方面的疗效.方法 将180例抑郁症患者随机分为氯丙咪嗪组、电休克组和米氮平组,每组60例,分别给予氯丙咪嗪静滴、无抽搐电休克和米氮平口服治疗.采用汉密尔顿抑郁量表(HAMD)和Beck自杀意念量表,于治疗前及治疗3、5、7、9、11、14、21 d评价疗效.结果 与治疗前相比,氯丙咪嗪组及电休克组Beck自杀意念量表评分在治疗的第3天就出现显著下降(P＜0.05),米氮平组则在7d才出现显著下降(P＜0.05).与米氮平组相比,氯丙咪嗪组及电休克组Beck自杀意念量表评分下降的幅度更大(P＜0.05).氯丙咪嗪组自杀观念的缓解率从第5天开始,电休克组从第3天开始均明显高于米氮平组(P＜0.05),在第7天,氯丙咪嗪组和电休克组自杀观念的缓解率分别达到了66.67％,70.90％,而米氮平组只有14.29％.结论 氯丙咪嗪静滴和电休克治疗一样可以快速改善抑郁症患者的自杀观念.
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