西酞普兰与阿米替林治疗老年抑郁症疗效与安全性的Meta分析

Comparative study of citalopram and amitriptyline in the treatment of senile depression:a Meta-analysis

目的运用Meta分析的方法评估西酞普兰与阿米替林治疗老抑郁症的疗效与安全性。方法应用计算机检索关于西酞普兰与阿米替林治疗老年抑郁症随机对照研究的文献,共有9个符合标准的随机对照研究纳入Meta分析。结果关于疗效的9个研究均属同质,合并效应量加权均数差值(WMD)为-0.48,95%可信区间为(-1.00,0.05),2组间差异无统计学意义(P>0.05);关于安全性的7个研究存在异质性,合并效应量WMD为-4.81,95%可信区间为(-6.02,-3.60),2组间差异有显著统计学意义(P<0.01)。结论西酞普兰与阿米替林治疗老年抑郁症疗效相当,阿米替林不良反应大于西酞普兰,西酞普兰具有较好的耐受性和安全性,应作为老年抑郁症的首选药物。

Objective To explore the clinical efficacy and safety of citalopram versus amitriptyline in the treatment of senile depression by Meta-analysis. Methods Electronic retrieval was performed from the medical literature for the randomized control study of citalopram and amitriptyline in the treatment of senile depression. Nine randomized control studies were found to meet the included criteria and then Meta-analysis was carried out. Results Nine studies of efficacy were homogeneity, with a total effect size （weighted mean difference, WMD） of -0. 48,95% confidence interval（95% CI） of （ - 1.00,0. 05 ）, P 〉 0. 05; Seven studies of safety were heterogeneity,with a total effect size （WMD） of -4.81,95% CI of （ -6. 02, -3.60）, P 〈 0.01. Sensitivity analysis showed that there was no difference between the result of fixed effect model and random effect model. Conclusions The results suggest that citalopram and amitriptyline are of the same efficacy in the treatment of senile depression. However, amitriptyline presents with more side effects, compared with citalopram. Citalopram is a first-line agent for the treatment of depression among the elderly patients with somato-disease.