艾司西酞普兰与氟西汀治疗老年抑郁症的对照研究

Comparison of escitalopram with fluoxetine in old depressive patients

目的：探讨艾司西酞普兰对老年抑郁症患者的疗效和安全性。方法：60例符合CCMD-3抑郁发作的老年抑郁症患者随机分为艾司西酞普兰组和氟西汀组，艾司西酞普兰剂量10～20mg·d^-1，氟西汀20～40mg·d^-1，疗效采用汉密尔顿抑郁量表（HAMD）评定，治疗期间进行不良反应量表（TESS）评定，同时在基线、2，6周作血常规、心电图、肝肾功能检查。观察时间为期6周。结果：艾司西酞普兰组显效率和治愈率兮别为70．4％和44．5％，氟西汀组为69．2％和42．3％，两组比较差异无显著性。艾司西酞普兰组在1周末HAMD评分与治疗前比较即有明显下降，氟西汀组下降不明显，且两组间差异显著（P〈0．05）。艾司西酞普兰组主要不良反应为食欲下降、恶心、头晕各3例次，失眠、口干、心动过速各2例次，便秘、嗜睡各1例次，与氟西汀组无显著差异。结论：艾司西酞普兰治疗老年抑郁症患者显效快，疗效和不良反应与氟西汀相似．

Objective ： To evaluate the efficacy and safety of escitalopram in the treatment of old depressive patients. Methods： In a randomized, open-labeled, 6-weeks flexible dose trial, 60 patients diagnosed as old depression based on CCMD-3 criteria were randomly assigned to 2 groups, and treated with eseitalopram 10 -20 mg per day or fluoxetine 20 -40 mg per day. Clinical effectiveness was evaluated by using HAMD, and adverse reactions were assessed with TESS. Meanwhile, several laboratory examinations such as blood routine, ECG, hepatic and nephritic function test were done at baseline, week 2 and 6. Results： The response rate and remission rate were 70.4% and 44.5% in escitalopram group, and 69.2% and 42.3% in fluoxetine group, respectively. No statistically significant difference in both rates was found between 2 groups. At the end of 1-week, HAMD score significantly decreased after treatment in escitalopram group but not in fluoxetine group, and significant difference existed between 2 groups （P 〈 0.05 ）. The main adverse reactions were lack of appetite, nausea, dizziness （ 3 cases in each group）; dry mouth and palpitation （2 cases in each group）; constipation and lethargy （1 case in each group）. No statistically significant difference in adverse reactions between 2 groups. Conclusion： Eseitalopram shows the efficacy more rapidly, while its efficacy and adverse reactions are similar to fluoxetine.