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Objective: to observe the effect differences and safety between acupuncture and sham acupuncture for female depression on the basis of conventional western medicine therapy., Methods: Forty-two patients with depression who met the criteria were randomly assigned into an observation group and a control group, 21 patients in each group. The basic treatment in the two groups was fluoxetine. The patients in the observation group were treated with acupuncture at Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4) and bilateral Shangqu (KI 17). Sham acupuncture was used at the above points in the control group. The treatment was given once a day on the first 3 days and once every 3 days after that, totally for 8 weeks. The scores of self-rating depression scale (SDS) and Montgomery Asberg depression rating scale (MADRS) were compared before and after 4-week and 8-week treatment in the two groups. The effects and adverse reactions were evaluated., Results: After 4-week and 8-week treatment, the SDS and MADRS scores were significantly lower than those before treatment in the two groups (all P <0.05), and the scores in the observation group were lower than those in the control group (both P <0.05). The improvements of SDS and MADRS scores in the observation group before and after treatment were better than those in the control group (both P <0.05). The total effective rates of SDS, MADRS scores were 85.7% (18/21), 90.5% (19/21) in the observation group, which were better than 38.1% (8/21), 57.1% (12/21) in the control group (both P <0.05). The adverse reactions in the observation group were significantly lower than those in the control group ( P <0.05)., Conclusion: Acupuncture combined with fluoxetine are effective and safe for female depression.

Objective: To understand the comorbid characteristics and distribution of combined treatment of Chinese and Western medicine in depressive patients., Method: The descriptive statistic method and association rule were used to analyze the data from 19 general hospitals with 3-A level in China., Result: Among the depressive disorder, the most frequent co-morbid physical diseases included hypertension (24.67%), coronary heart disease (16.10%) and cerebral infarction (12.89%), and the proportion of comorbid changes with the increasing age, from 6.51% to 12.55%, 16.33% and 12.47% for hypertension; from 2.79% to 5.69%, 10.17% and 14.22% for coronary heart disease; from 3.72%, 6.27%, 7.70% and 12.25% for cerebral infarction. The use frequency of the antidepressants is 77.18%, and the use frequency of flupentixol & melitracen is 20.95%. The use frequency of Huoxue Huayu Tongluo of traditional Chinese medicine is 59.97%, with that of 27.91% for Ginkgo biloba extract The combined use frequency of Huoxue Huayu Tongluo of TCM and the antidepressants is the highest, especially for the combined use of Shuxuening injection and fluoxetine., Conclusion: The most frequent comorbid diseases of depression include three kinds of diseases, such as hypertension, coronary heart disease and cerebral infarction, and its proportion gradually increased with the growth of age. The single use frequency of flupentixol & melitracen and G. biloba extract is the highest, while the combined use of Shuxuening injection and fluoxetine is the highest.

To study the effect of early intervention of liver-soothing and Blood-activating decoction combined with acupuncture in improving neurological functions, depressive symptom and life quality of patients with post-stroke depression, and compare with fluoxetine hydrochloride. Specifically, 63 patients with post-stroke depression were randomly divided into the traditional Chinese medicine (TCM) acupuncture group (31 cases) and the western medicine group (32 cases). On the basis of the conventional treatment of the primary disease, the TCM acupuncture group was treated with liver-soothing and blood-activating decoction and acupuncture, while the western medicine group was treated with fluoxetine hydrochloride for four weeks. In the follow-up visit six months later, scores of HAMD, NIHSS and SS-QOL were observed. The scores of HAMD and NIHSS of both groups were significantly decreased (P < 0.01), while the scores of SS-QOL increased significantly, with a notable difference compared with that before the treatment (P < 0.01). Specifically, the TCM acupuncture group's was superior to the western medicine group (P < 0.05). The study suggests that the early intervention of liver-soothing and blood-activating decoction combined with acupuncture on patients with post-stroke depression has the effect in relieving depression symptom and improving neurological functions, thereby improving their quality of life and prognosis.

Objective: To observe the change of serum homocysteine (Hcy) and anti-citrullinated peptide (CCP) antibody concentration in depression rat model induced by chronic unpredictable mild stress (CUMS), and to explore the immunologic mechanism of depression and the relation between depression and its autoimmunity., Methods: Sixty adult male SD rats were randomly divided into 2 groups, 30 rats in each group, which were divided into 3 subgroups: a normal control group, a model group and a fluoxetinetreated group. The depression rat model was established under CUMS and seperated feeding, after which, open field, sugar consumption and forced swimming test were applied in the first group. After the blood was taken in the second group of rats through heart puncture, the level of serum Hcy was detected by enzymatic cycling assay and serum anti-CCP antibody by ELISA., Results: Compared with the control group and the fluoxetine treatment group, spontaneous activity and sucrose consumption and preference percentage of the rats in the model group significantly reduced, while the immobility time in forced swimming test and the level of Hcy and anti-CCP antibody in the rat serum significantly increased., Conclusion: Immunity inflammation and autoimmune reaction exist in CUMS depression model rats, and fluoxetine treatment can improve these immune response.

Objective: The study aimed to investigate the relationship between arrhythmia occurrence and nerve remodeling of thoracic spinal cord 1-5 nerves as well as myocardial electrophysiological remodeling in a metal stress rat model., Methods: Thirty SD rats (weight 180-250 g) were randomly divided into control group (n = 10), stress group (n = 10) and fluoxetine group (n = 10, 10 mg/kg i.p. for 3 weeks). Stress model (given by unpredicted chronic mild stress) was established according to Cronli's protocol. Following parameters were observed:(1) ECG waveform change and arrhythmias;(2) tissue field action potential duration (FAPD) of thoracic spinal cord 1-5 and cardiac tissue mapped by microelectrode arrays (MEA) technique;(3) myocardial growth-associated protein (GAP-43), tyrosine hydroxylase (TH), choline acetyltransferase (CHAT) distribution observed by immunofluorescence and confocal laser scanning microscope (LSCM)., Results: Three weeks later: (1) The body weight, food intake, consumption of sugar water, the horizontal and vertical movement score, cleaning action of rats were significantly decreased, and fecal grains significantly increased, P-wave, P-R interval, QRS-wave and Q-T interval were significantly prolonged and heart rate was significantly reduced in stress group compared with control group (all P < 0.05). Incidence of ventricular premature beat was 80% in stress group and 0% in control group (P < 0.05). The FAPD of thoracic spinal cord 1-5 nerves [(144.25 ± 12.63)ms vs (79.56 ± 8.01)ms] and of cardiac tissue [LA(122.43 ± 19.34)ms vs (92.59 ± 7.61)ms, RA(149.89 ± 14.68)ms vs (105.18 ± 15.94)ms, LV(162.62 ± 7.04)ms vs (110.45 ± 6.92)ms, RV(152.21 ± 30.49)ms vs (131.06 ± 12.04)ms] were significantly prolonged, FAPD dispersion (FAPDd) significantly increased [thoracic spinal cord 1-5(13.3 ± 9.11)ms vs (9.36 ± 7.01)ms] in stress group compared with the control group. Disarrangement of myocardial cells, proliferation of collagen fiber, infiltration of neutrophil and lymphocytes in the cardiac tissue were also observed and distribution of GAP-43, TH and CHAT was significantly increased in stress group. (2) All these changes could be partly reversed by the treatment with fluoxetine., Conclusion: Metal stress induced cardiac autonomic nerve and myocardial electrophysiological remodeling and ventricular arrhythmia in rats which could be significantly attenuated by fluoxetine in this model.

Objective: To explore the mechanism of depression treatment by needling at Taichong (LV3) and the correlation between the liver meridian and the frontal lobe., Methods: Forty-two patients with moderate depression at the first attack in line with Diagnostic and Statistical Manual of Mental Disorders (4th ed) by American Psychiatric Association were assigned to the fluoxetine group, the needling + fluoxetine group, and the needling group, 14 in each. The therapeutic course for them all was one month. Resting fMRI scanning was performed before and after treatment using 3.0 T magnetic resonance. Data were analyzed using fractional amplitude of low frequency fluctuations (fALFF). Paired t-test was used for comparison. Correlation analysis was performed in the fALFF images after treatment and Hamilton's depression scale., Results: Compared with before treatment, fALFF values in the left frontal lobe (BA6, BA9, BA48), the right frontal lobe (BA4, BA46), the bilateral inferior parietal lobules (BA40, BA48), the precuneus (BA7), the posterior cingutate (BA31), the left occipital lobe (BA17), and the right occipital lobe (BA18) of the needling +fluoxetine group were lowered (P<0.05). fALFF values in the right inferior parietal lobule (BA40) and the right occipital lobe (BA17) of the fluoxetine group were lowered (P<0.05). fALFF values in the left frontal lobe (BA10), the right frontal lobe (BA45), the left occipital lobe (BA19), the right occipital lobe (BA17), the left precuneus (BA7), and the posterior cingutate (BA31) were lowered in the needling group (P<0.05). Hamilton's depression scale was positively correlated with the fALFF value in the left frontal lobe of the needling +fluoxetine group and the needling group, while Hamilton's depression scale was positively correlated with the fALFF value in the left middle frontal gyrus, the left parietal lobe, and the left occipital lobe in the fluoxetine group., Conclusions: Combination of needling and antidepressive agents was superior to needling or antidepressive agents alone. Changes of the frontal lobe functions were correlated with the severity of depression. More extensive correlation existed between the liver meridian and the frontal lobe, which might be the antidepressive mechanism of needling Taichong (LV3).

Objective: To investigate the anti-depressant effect and the possible mechanism of Xiaoyao Wan in animal models., Methods: The open-field test and the forced swimming test were applied to study the anti-depressant effect of Xiaoyao Wan in mice, and HPLC-ECD was carried out to assay the contents of 5-HT and 5-HIAA, and the mechanism of Xiaoyao Wan on anti-depressant effect was discussed., Results: Xiaoyao Wan at the dose of 200, 400 and 600 mg/kg significantly increased the revolutions in force swimming test, and ameliorated brain cortex 5-HT and 5-HIAA content of restraint mice. But there was no effect on brain cortex 5-HT and 5-HIAA content of non-restraint mice., Conclusion: Xiaoyao Wan has significant anti-depressant effect which may be related to the potentiation of brain serotonergic function.

Objective: To study on clinical therapeutic effect and safety of electroacupuncture and Fluoxetine for treatment of mild or moderate depression with physical symptoms., Methods: Seventy-five cases were randomly divided into a western medicine group (group A), an electroacupunctue group(group B) and an electroacupuncture plus medicine group (group C), 25 cases in each group. The group A were treated by oral Fluoxetine, 20 mg each day; the group B by electroacupuncture with Baihui (GV 20) and Yintang (EX-HN 3) selected as main points; the group C by oral administration of Fluoxetine plus electroacupunctue. HAMD depression scale was used for assessment of clinical therapeutic effect and TESS adverse reaction scale was used for adverse reactions., Results: The clinical effective rate was 78.3% in the group A, 82.6% in the group B and 91.7% in the group C, with significant differences between group C and A, group C and B (P < 0.05). Groups B and C had significant therapeutic effects in improvement of physical symptoms, and the adverse reaction of Fluoxetine in the group C was less than that in the group A., Conclusion: Electroacupuncture can significantly improve physical symptoms and relieve adverse reactions of Fluoxetine. Electroacupuncture combined with Fluoxetine has a better therapeutic effect on depression with mild or moderate physical symptoms, with less adverse reactions.

Objective: To develop a mouse model to mimic the behavioral and neurochemical changes of Tourette syndrome (TS) by 1-(2, 5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) induction and to investigate the effects of fluoxetine and haloperidol on head twitch response (HTR) induced by DOI., Methods: 1) Preparation of mouse model of TS: Forty mice were randomly divided into experimental and control groups (n=20 each). DOI (1 mg/kg) was administered by peritoneal injection in the experimental group. The control group was injected with normal saline. The levels of dopamine (DA) and homovanillic acid (HVA), the metabolite of DA, in both groups were measured by high performance liquid chromatography and electrochemical detection. 2) Effects of fluoxetine and haloperidol on HTR: Eighty mice were randomly administered with either fluoxetine (2 mg/kg), haloperidol (0.8 mg/kg), fluoxetine + haloperidol or normal saline. DOI (1 mg/kg) was peritoneally injected 20 minutes later (acute trial) or 18-20 hrs after a 21 days injection of fluoxetine or haloperidol (chronic trial). The frequency of DOI induced HTR was observed immediately after DOI injection., Results: The levels of DA and HVA in the experimental group were significantly lower than those in the control group (DA: 45.00 +/-11.24 ng/mg vs 58.16 +/-14.51 ng/mg; HVA:10.54 +/-1.86 ng/mg vs 12.82 +/-2.66 ng/mg). In both acute and chronic trials, the frequency of DOI-induced HTR decreased significantly in mice administered with haloperidol alone or together with fluoxetine (P < 0.05), but it did not change significantly in mice administered with fluoxetine alone compared with the normal saline group., Conclusions: The levels of DA and HVA are reduced in mice with DOI-induced HTR. DOI-induced mouse mode of HTR can mimic the neurochemical and behavioral changes of TS paritially. Haloperidol can inhibit DOI-induced HTR in mice, but fluoxetine can not.

Objective: To evaluate the efficacy of Wuling Capsule (WLC) in treating patients with poststroke depression., Methods: One hundred and eight patients with poststroke depression were randomly assigned to three groups, 36 in each. All were treated with routine medicine, but to the WLC group and the FLX group, additional WLC and fluoxetine was given respectively, while to the combined group, both of the two were given. Patients' neurological and cognitive function were estimated by HAMI) scale, MMSE scale, SSS scale and Barthel index (BI) before treatment and at 4 weeks and 12 weeks after treatment., Results: HAMD score and SSS score significantly decreased (P < 0.01) while MMSE score and BI score significantly increased (P <0.05) in all the three groups, but the improvement in decrease of HAMD score and in increase of BI score in the combined group was more significant than those in the other two groups respectively (P<0.05)., Conclusions: WLC is effective in treating patients with poststroke depression and shows synergism with fluoxetine.

Objective: To study the effects of antidepression drugs and hormone replacement therapy (HRT) in perimenopausal and postmenopausal women with depression., Methods: Eighty six perimenopausal and postmenopausal women with depression were divided into two groups, and treated for 12 weeks, respectively. Forty three received antidepression drugs as control group. Among them, mild to moderate depression were treated with deanxid (1 - 2 pills/d), and severe depression with fluoxetine (20 mg/d). Another 43 took Tibolone (livial) as HRT group (1.25 mg/d). All patients were assessed with the Hamilton depression rating scale for depression (HRSD) and self rating depression scale (SDS) before and at weeks 4, 8, 12 after treatment., Results: (1) Total effective rate of control and HRT groups was 96% and 93%, respectively, in mild-moderate depression (chi(2)=0.012, P>0.05), while there was a significant difference between two groups in severe depression. The overall effective rates were 93% (control group) and 42% (HRT group), respectively (chi(2) = 5.72, P < 0.01). (2) HRSD of mild-moderate depression was 26.8 +/- 5.7, 10.7 +/- 3.6, 6.4 +/- 3.6, 3.5 +/- 2.5, respectively in control group, and were 25.3 +/- 4.7, 15.2 +/- 5.3, 11.4 +/- 4.4, 4.4 +/- 3.8 in HRT group before and at weeks 4, 8, and 12 after treatment. There was no difference between two groups at weeks 0, and 12 after treatment (P>0.05). HRSD scores of severe depression were 37.6 +/- 5.6, 21.4 +/- 5.2, 14.2 +/- 4.2, 7.3 +/- 2.3, respectively, in control group, and were 38.2 +/- 4.8, 32.6 +/- 5.4, 28.2 +/- 4.6, 24.3 +/- 4.5, respectively, in HRT group before and at weeks 4, 8, and 12 after treatment. There was no difference in HRSD before treatment (P>0.05), but a significant difference at weeks 4, 8, and 12 between two groups (P<0.01). (3) SDS of mild and moderate as well as severe depression was significantly different at weeks 0, 4.8, and 12 in control group (P<0.01), while there was a difference in SDS of severe depression before treatment and at weeks 12 in HRT group (P<0.05). A significant reduction in HRSD and SDS of severe depression was demonstrated in control group than in HRT group (P<0.01), Conclusion: Antidepression drugs and HRT can improve symptoms of depression in perimenopausal and postmenopausal women, but the effect of antidepression drugs is much better than HRT, especially in severe depression.

Objective: To observe the curative effect of acupuncture following principle of relieving depression and regulating mentality (RDRM) in treating patients with melancholia, and compare it with that of Western medicinal treatment., Methods: Patients in the observed group were treated with needling and electroacupuncture (EA), and those in the control group orally taken Fluoxetine or Paroxetine. The curative effect, Hamilton Depression Scale scores (HAMD), effect initiating time and sustaining time were observed and compared., Results: The total effective rate was 87.5% and 79.1% in the observed group and the control group respectively, showing insignificant difference between them (P > 0.05), but comparison of the initiating time and sustaining time between the two groups did show significant different (P < 0.01)., Conclusion: Acupuncture with following RDRM principle has definite effect in treating melancholia, which is comparable to Western medicinal treatment, and shows a superiority to the latter in effect initiating and sustaining time.

Objective: We observed the therapeutic effectiveness and safety of different antidepressants as well as the correlation between symptomatic improvement of depression and improvement of chest pain in patients with susceptible "angina pectoris" and negative coronary angiogram complicating comorbid depression., Methods: In this double-blinded randomized study, a total of 123 eligible patients were allocated into three groups: (1) Group F: fluoxetine 20 mg QN (n = 41); (2) Group P: Placebo 1 tablet QN (n = 40); (3) Group F + O: fluoxetine 20 mg + olanzapine 2.5 mg QN for the former 2 weeks and only fluoxetine 20 mg QN for the latter 2 weeks (n = 42). The total therapy duration was 4 weeks. HAMD, HAMA and self-evaluation table of chest pain were obtained before therapy, at the end of 1 and 2 weeks after therapy., Results: Baseline HAMD and HAMA scores and self-evaluation score of chest pain were similar among 3 groups and all scores were significantly improved post various therapies in the order of group F + O > group F > group P. The rate of score decrease were seen after 1 week treatment in group F + O and after 2 week treatment in group F. There was a significant positive correlation between the rates of self-evaluation chest pain score decrease and HAMD (r = 0.867, P < 0.001) and HAMA (r = 0.854, P < 0.001) score decreases after 4 weeks therapies (P < 0.05). During the whole course of treatment, no serious adverse reaction was found in all patients., Conclusion: In patients with suspected "angina pectoris" and negative coronary angiogram complicating comorbid depression, the antidepressants were safe and significantly improved the symptoms of depression and anxiety and chest pain. Low dose fluoxetine plus short term olanzapine regimen was superior to fluoxetine alone regimen in terms of stronger and quicker symptom improvement.

Objective: To explore the effect of antidepressant treatment on antihypertensive therapy of senile hypertension., Methods: 138 cases of senile hypertension complicating with depression were studied. 103 senile hypertensive patients without depression in the same period served as controls. The patients were randomly divided into 3 groups as A, B and C for study. 12.5 mg/d hydrochlorothiazide and 30 mg/d release-controlling tablets of nifedipine were orally administrated as basic antihypertensive medication each group. Besides, 20 mg/d fluoxetine was additionally given to groups A and one tablet of almitrine l/d and 20 mg oryzanol 3/d were given to group B. The treatment lasted 12 weeks., Results: In comparison with pre-treatment, the blood pressure at base line in sitting position and the average circadian SBP and DBP monitored with 24-hour ambulatory blood pressure monitoring (ABPM) was remarkably decreased in group A with statistical significance (P < 0.01). These blood pressure parameters in group B were also decreased as compared ith the pretreatment level brt with less statistical significance (P > 0.05). It was also noted tha with the addition of antidepressant fluoxetine, the manifestations of depression ere alleviated as shown by Hamilton depression (HAMD) scale. untoward reactions such as nausea, perspiration and skin rash were noted in a few patients, but none withdrew from the study., Conclusions: Antidepressant and antianxiety treatment is of benefit to the antihypertensive therapy in senile hypertensive patients with complications of depression and/or anxiety neurosis. Based on the results of this study, it is suggested that routine administration of antidepressants and antianxiety drugs should be carried out in senile hypertensive patients complicating with depression or anxiety.

Objective: To compare the ettect and side-ettect of fluoxetine and combination of fluoxetine and Chinese or Tibetan medicine in treating senile depression in plateau district. Methods Ninety patients with diagnosis of senile depression conformed to CCMD-3 standard, in plateau district of 2260 - 3200 m altitude were randomly divided into three groups and treated with fluoxetine (group A), fluoxetine plus Sanpu Xinnao Xin granule (group B) and fluoxetine plus Xiaoyao pill (group C), respectively, 30 cases in each group. Therapeutic effects were evaluated with Hamilton' s depressive scale (HAMD) and treatment emergent symptom scale (TESS) after 6 weeks treatment., Results: There was no significant difference in the therapeutic effects between the three groups. The adverse reaction in Group B and C was less than that in Group A (P<0.01). Conclusion Sanpu Xinnao Xin granule and Xiaoyao pill can raise the tolerance of patients with senile depression in plateau area against the adverse reaction of fluoxetine.

Objective: To compare the treatment effects between fluoxetine plus hormone replacement therapy (HRT) and HRT alone on menopausal depression., Methods: A total of 54 women with climacteric symptoms and depression were enrolled and randomly divided into two groups. The fluoxetine plus HRT group received fluoxetine (20 mg, qd, po) and cyclic use of conjugated estrogen 0.625 mg and medroxyprogesterone acetate 5 mg, while HRT group was assigned to receive cyclic use of conjugated estrogen 0.625 mg and medroxyprogesterone acetate 5 mg only. All subjects were interviewed and evaluated with Hamilton Depression score (HAMD) and Kupperman menopause index (KMI) at week 0, 1, 2, 3, 4, 6 and 8 of the treatment., Results: There was no difference between two groups in HAMD and KMI before the trial (P > 0.05). HAMD scores at the 8th week in fluoxetine plus HRT group and HRT group were 3.0 +/- 2.3 and 11.2 +/- 5.8 respectively, being significantly different (P < 0.001). At the 6th week of treatment KMIs in fluoxetine plus HRT group and HRT group were 9 +/- 6 and 14 +/- 7 respectively, also significantly different (P < 0.05). The healing rates of fluoxetine plus HRT group and HRT group were 92% and 48% respectively, which were statistically different by Chi square test (P < 0.001)., Conclusions: The effect of fluoxetine plus HRT on menopausal depression is significantly superior than that of HRT only and the difference becomes more obvious with treatment time. Both groups could ameliorate the climacteric symptoms with the effect of fluoxetine plus HRT more obvious.

Objective: To study the influence of Jieyu Huoxue Decoction on rehabilitation of patients with depression after cerebral infarction., Methods: Fifty four patients suffered from the depression after acute cerebral infarction were randomly divided into three groups: depression control group, fluoxetine treated group and Jieyu Huoxue Decoction treated group. Eighteen patients of cerebral infarction without depression were enrolled in the no depression control group randomly. The Zung self-rating depression scale (SDS), the modified Edinburgh-Scandinavia stroke scale (MESSS) and the activities of daily living (ADL) were evaluated before treatment, 30 and 60 days after treatment., Results: After 30 and 60 days of treatment, SDS evaluation of the Jieyu Huoxue Decoction treated group showed significant difference as compared with the condition before treatment and that of the depression control group (P < 0.05 or P < 0.01), MESSS evaluation and ADL evaluation also showed significant difference as compared with the condition before treatment and that of the depression control group (P < 0.05 or P < 0.01); there was no obvious difference between the fluoxetine treated group and the Jieyu Huoxue Decoction treated group, but the Jieyu Huoxue Decoction treated group showed fewer symptoms and less side effect., Conclusion: Jieyu Huoxue Decoction can not only relieve depression after cerebral infarction, but also improve neurological functions.

Objective: To observe the influence of antidepressive therapy on short-term prognosis in elderly unstable angina pectoris patients with depression., Methods: 76 unstable angina pectoris patients were random into a therapy group (38) and control group (38). Patients in the therapy group were treated with psychotherapy and administration of antidepressant Fluoxetine (Prozac Eli Lilly, USA) 20mg once a day on the basis of regular cardiac medicine therapy for 12 weeks, Patients in the control group were only treated with regular cardiac medicine therapy., Results: Myocardial ischaemia in the therapy group was significantly improved. The recurrence rate of angina pectoris and incidence ratio of acute myocardial infarction in the therapy group were low. There was significant difference in comparison with the control group (P < 0.05)., Conclusion: Antidepression can significantly improve the short-term prognosis in elderly unstable angina pectoris patients.