药品信息: 药品简介
依地普仑获瑞典、瑞士、丹麦、比利时、英国、法国、爱尔兰和奥地利等欧洲国家许可,现已在瑞士、瑞典和英国上市,商品名为 Cipralex。
依地普仑是西酞普兰( Citalopram)的活性S-对映异构体,去除了无抗抑郁活性的 R-对映异构体。临床研究显示了依地普仑的疗效和耐受性好。其推荐剂量为一日10mg,而西酞普兰为一日40mg。此外,许多病人每日服用依地普仑10mg,治疗第1周或第2周后开始显著改善抑郁症状。
依地普仑 10mg在主要疗效上同西酞普兰40mg相似。
依地普仑Escitalopram 是一种新型的选择性5一羟色胺再摄取抑制剂(SSRIs)。选择性5一羟色胺再摄取抑制剂已取代了三环类抗抑郁药物成为抑郁治疗的一线用药,其原因在于它们不仅具有三环类抗抑郁药相似的疗效,同时具有相对较好的耐受性以及过量时较好的安全性。
草酸依地普仑是单纯的SSRIs,其对5一羟色胺再摄制抑制的相对选择性在同类药物中最高,抗抑郁作用优于西酞普兰,起效快.服用剂量小,耐受性好,副反应小,药物相互作用少等优点,可以与其他药物联合应用。与其他SSRIs一样,成为抗重性抑郁的第一线用药。最常见的副反应是恶心、失眠、射精障碍、腹泻、口干、思睡,只有恶心发生率>10% 。
用法用量
成人:草酸依地普伦每日服用一次。开始10 mg/d,如临床适应剂量可增加至20 mg/d,或有需要时增加至30 mg/d。超过65岁的患者,剂量减半,即5-15 mg/d。抗抑郁剂治疗属于对症治疗,必须持续相当长的时间,一般说来对双相障碍性一抑郁障碍需要治疗4-6个月。
若出现失眠或严重的静坐不能,在急性期建议辅助镇静剂治疗。
任何疑问,请遵医嘱!
安全性/耐受性
Wade(2002)报道:草酸依地普仑的副作用通常很少,很轻,且短暂。最常见的副反应有:恶心、多汗、口干、头痛和睡眠时间缩短。通常在治疗开始的第1或第2周时较明显,随着抑郁状态的改善一般都逐渐消失。在稀有个案中曾观察到癫痫发作。在已患有心动过缓的患者中,心动过缓可使治疗更复杂。
与三环类抗抑郁药相比,草酸依地普仑很少引起过度镇静、嗜睡、体质量增加、和直立性低血压、性功能障碍等副反应。尤其无体质量增加及性功能障碍使得依地普仑远比三环类抗抑郁药易于为患者接受。
草酸依地普仑在人怀孕期的安全性尚未确定,动物实验未显示任何致畸形可能的证据。并且,不影响生殖或产期状态。不影响心脏传导系统及血压,这一点对老年患者尤为重要。也不影响血液,肝肾等系统。
药物过量
药物过量时,达6OO mg出现疲乏、无力、嗜睡、头晕、手颤、恶心。最高服用剂量记录约为2,000mg,患者在木僵及呼吸困难状态下入院,但没有心脏中毒的迹象,患者很快康复。
禁用
禁用于已在使用单胺氧化酶抑制剂治疗者,单胺氧化酶抑制剂至少停用14 d后方可使用本品。禁用于对本药品制剂成份有过敏史者。
与单胺氧化酶抑制剂合用时会出现致命的5一羟色胺综合征,因此两药使用间隔应在14 d以上。
Drugs Introduction
Escitalopram eligible European countries permit Sweden, Switzerland, Denmark, Belgium, Britain, France, Ireland and Austria, are now available in Switzerland, Sweden and the United Kingdom, under the trade name Cipralex.
Escitalopram is citalopram (Citalopram) activity S- enantiomer, in addition to no antidepressant activity of R- enantiomer. Clinical studies have shown the efficacy of escitalopram and well tolerated. Its recommended dose for day 10mg, while citalopram for day 40mg. In addition, many patients daily doses of escitalopram 10mg, one week after treatment or second week significantly improve symptoms of depression.
10mg escitalopram with citalopram 40mg similar on the primary efficacy.
Escitalopram Escitalopram is a novel selective 5-HT reuptake inhibitors (SSRIs). Selective 5-HT reuptake inhibitors have replaced tricyclic antidepressants become the treatment of first-line treatment of depression, the reason is that they not only have similar efficacy of tricyclic antidepressants, while having a relatively well tolerated and overdose better security.
Escitalopram oxalate is simple SSRIs, its 5-HT re-filmed relatively selective inhibition of the highest in the similar drugs, the antidepressant citalopram was superior, rapid onset. Taking small doses, well tolerated, side effects of small, less drug interactions, etc., can be combined with other drugs. Like other SSRIs, anti-major depression become first-line medication. The most common side effects are nausea, insomnia, ejaculation disorder, diarrhea, dry mouth, somnolence, nausea rate only occurred> 10%.
Dosage
Adults: escitalopram oxalate taken once daily. Increased to 30 mg / d starting 10 mg / d, such as clinical dose may be increased to accommodate 20 mg / d, or when necessary. Patients over 65 years of age, the dose by half, ie 5-15 mg / d. Antidepressants belong symptomatic treatment must continue for a long period of time, generally for bipolar disorder of a depressive disorder in need of treatment 4-6 months.
If insomnia or serious meditation there can not, in the acute phase treatment recommendation sedatives aid.
Any questions, please doctor!
Safety / tolerability
Wade (2002) reported: escitalopram oxalate side effects usually small, very light and short. The most common side effects are: nausea, sweating, dry mouth, headache, and sleep time. Usually more obvious at the start of treatment in the first or second week, with the improvement of depression generally disappearing. In rare cases of seizures have been observed. In patients already suffering from bradycardia, the bradycardia can make treatment more complicated.
Compared with tricyclic antidepressants, escitalopram oxalate rarely cause excessive sedation, drowsiness, increased body weight, and adverse orthostatic hypotension, sexual dysfunction. In particular, no increase in body weight and sexual dysfunction makes escitalopram than tricyclic antidepressants easy for patients to accept.
Escitalopram oxalate in human pregnancy has not been established safety, animal experiments no teratogenic potential evidence is not shown. Also, do not affect the reproductive or birth status. It does not affect the cardiac conduction system and blood pressure, which is especially important for elderly patients. It does not affect the blood, liver and other systems.
Drug overdose
When drug overdose, up 6OO mg appear fatigue, weakness, drowsiness, dizziness, tremor, and nausea. Recording the highest dose is about 2,000mg, patients admitted to hospital in the state of stupor and breathing difficulties, but there is no evidence of cardiac toxicity, the patient soon recovered.
Disabled
Has been banned from using monoamine oxidase inhibitor therapy, monoamine oxidase inhibitors can disable at least 14 d behind the FDA. Banned ingredients of this pharmaceutical preparations have a history of allergies.
There will be five fatal serotonin syndrome in combination with monoamine oxidase inhibitor, and therefore the use of the two drugs should be spaced at least 14 d. |