度洛西汀与舍曲林治疗老年抑郁症的疗效和安全性

Efficacy and safety of duloxetine and sertraline in treatment of senile depression

目的评价度洛西汀与舍曲林治疗老年抑郁症的疗效和安全性。方法71例老年抑郁症患者随机分为2组,度洛西汀组(35例)和舍曲林组(36例),所有患者均经2周清洗期,疗程为6周。度洛西汀组口服度洛西汀,起始剂量40mg.d-1,2周后加至60 mg.d-1,直到观察结束;舍曲林组口服舍曲林,起始剂量25 mg.d-1,2周后加至50～100 mg.d-1,直到观察结束。使用汉密尔顿抑郁量表(HAMD)、不良反应症状量表于治疗前,治疗1,2,4,6周后评估疗效和安全性。结果经过6周治疗,度洛西汀组显效率和有效率分别为80%和97%,舍曲林组分别为78%和94%,组间差异无统计学意义(P>0.05)。治疗第1,2周疗效差异有统计学意义(P<0.05或P<0.01),表明度洛西汀组1周内就能起效,较舍曲林组起效快。2组抗抑郁药治疗老年抑郁症均有效,且疗效相当,不良反应轻微。结论度洛西汀与舍曲林治疗老年抑郁症安全、有效,但度洛西汀起效更快。

Objective To observe the efficacy and safety of duloxetine and sertraline in the treatment of senile depression. Methods Seventy - one cases of senile patients with depression were randomly divided into two groups, the duloxetine group （35 cases） and the sertraline group （36 cases） , all patients after 2 weeks washout period, treatment for 6 weeks. Duloxetine group and sertraline group were treated with duloxetine and sertraline oral starting dose 40 mg · d-1 and 25 mg · d-l, after two weeks the initial dose plus to 60 mg · d-1 and 50 - 100 mg · d-1, respectively. The efficacy and safety of the two groups were evaluated with the Hamilton Depression table （HAMD） , adverse symptoms scale before and after 1, 2, 4, 6 weeks of treatment. Results After 6 weeks of treatment, the efficiency and the effective rate were 80% and 97% in duloxetine group,78% and 94% in sertraline group, there were no significant difference between the two groups （ P 〉 0.05 ）. After 1,2 weeks of treatment, there were significant difference between two groups （ P 〈 0. 05 or P 〈 0.01 ）, which indicated that duloxetine group took effect in one week and took effect faster than sertraline group. It was effective in the trearment on senile depression with two antidepressants, curative effects were equivalent, and adverse reactions were mild. Conclusion Duloxe- tine and sertraline were safe and effective in treatment of senile depres- sion, but duloxetine takes effect more quickly.