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학술저널

6개월간의 주요우울장애 환자에서 Venlafaxine 단독요법 및 Olanzapine 병합요법의 치료 중단율

본 연구에서 나타난 결과들은 항정신병 약물 병합군에서 더 높은 약물 순응도와 치료 효과를 나타내었다. 이는 우울증 환자들 에게서 항정신병 약물을 같이 처방함으로써 항우울제 단독으로 사용하는 것보다 환자의 약물 순응도를 높이고 치료 기간을 유지시켜 줌으로써 더 나은 치료효과를 나타낼 수 있을 것으로 보인다.

Objectives:Antipsychotics augmentation is suggested as one of the strategies to improve the effectiveness of antidepressants in the treatment of major depressive disorder. This study calculated time to discontinuation of ven-lafaxine monotherapy group and olanzapine augmentation group with major depressive disorder during 6 months and discussed the effectiveness of olanzapine augmentation. Methods:We collected the data from medical records of patients who visited psychiatric outpatient clinic of Bongseng memorial hospital and were prescribed by venlafaxine XR alone, or combination of venlafaxine XR and olanzapine on first visit from Aug. 2006 to Aug. 2007. We measured time to discontinuation (no more visit), the degree of adherence by medication possession ratio (MPR) from first visit until 6 months. The degree of CGI-I, CGIS scores and dosages of each medication were also assessed by monthly for 6 months. We used chi-square test and ttest, Kaplan Meier method to analyze group differences in demographic data and clinical characteristics, treatment efficacy and survival analysis. Results:The mean survival time of augmentation group was longer than monotherapy group (129.55 days vs 99.86 days, log rank test p=0.0342). The difference of CGI-S between two groups was not different significantly (4.4 vs 4.3, p=0.743) at baseline but CGI-I of augmentation group was better than monotherapy group (1.8 vs 2.8, p<0.001) at first month. Augmentation group showed higher MPR than monotherapy group but statistically not sig-nificant (0.950 vs 0.908, p=0.351). Conclusion:Our results suggest olanzapine augmentation would be able to increase treatment adherence and effectiveness.

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