艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的对照研究

Comparative Study of Escitalopram and Paroxetine in Treatment of Elderly Post-Stroke Depression

目的探讨艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的临床疗效及安全性。方法将68例患者随机分为A组和B组,各34例,A组口服草酸艾司西酞普兰,B组口服帕罗西汀。两组于治疗前和治疗后1,2,4,8周末采用汉密尔顿抑郁量表(HAMD)评定疗效,不良反应量表(TESS)评定不良反应。结果两组治疗后HAMD评分均较治疗前显著下降,差异有统计学意义(P<0.01);A组和B组疗效总有效率分别为94.12%和91.18%,不良反应率分别为35.29%和38.24%,差异均无统计学意义(P>0.05)。结论艾司西酞普兰与帕罗西汀治疗老年脑卒中后抑郁的疗效相当,但艾司西酞普兰起效更快,不良反应更轻,适合作为老年脑卒中后抑郁患者的一线用药。

Objective To evaluate efficacy and safety of escitalopram and paroxetine in the treatment of post stroke depression in eider patients. Methods Sixty eight elder patients with post stroke depression were randomly divided into the group A and B, 34 cases in each group. The group A took oral escitalopram oxalate and the group B took oral paroxetine. The efficacies of before treatment and in post treatment 1, 2, 4, 8 weeks were evaluated according to the Hamilton rating scale for depression（HAMD）, and the adverse reactions according to the treatment emergent side effect scale（TESS）. Results The scores of HAMD after treatment were significantly decreased than before treatment in the two groups with statistical difference （P〈0. 01）. The total effective rates in both two groups were 94.12% and 91. 18%, and the rates of adverse reactions were 35.29% and 38.24%, respectively, which were not statistically different between the two groups. Conclusion The efficacy of escitalopram and paroxetine in the treatment of post stroke depression in elder patients is similar, but escitalopram has faster effect and milder adverse reactions than paroxetine, and is suitable to be used as the first line drug.