安非他酮与艾司西酞普兰治疗老年期抑郁症的临床疗效及安全性

Comparison study of bupropion and escitalopram in treatment of elderly depression

目的比较安非他酮缓释片与艾司西酞普兰治疗老年期抑郁症的效果及安全性。方法选取2012年4月至2014年11月就诊的97例老年抑郁症患者。分为安非他酮组49例和艾司西酞普兰组48例,分别口服安非他酮缓释片与艾司西酞普兰治疗8周。采用汉密尔顿抑郁量表(HAMD)评定临床疗效,采用大体评定量表(GAS)评定总体功能情况,采用不良反应量表(TESS)评估治疗的安全性。结果安非他酮组43例,艾司西酞普兰组44例完成本研究。与治疗前比较,治疗8周后2组HAMD评分均较治疗前降低(P<0.01),GAS评分均较治疗前增加(P<0.01)。组间比较,治疗8周后2组患者HAMD评分及GAS评分差异均无统计学意义(P>0.05)。安非他酮组显效率(HAMD减分率≥50)为60%,艾司西酞普兰组显效率为59%,差异无统计学意义(P>0.05)。2组患者不良反应发生率差异无统计学意义(P>0.05)。结论安非他酮缓释片与艾司西酞普兰治疗老年期抑郁症均安全有效,2种药物的治疗效果及安全性基本相当。

Objective To explore the effect and safety of bupropion and escitalopram in treatment of elderly depression.Methods Ninety-seven elderly depression patients recruited from April 2012 to November 2014 were randomly assigned into two groups：49in bupropion group and 48 in escitalopram group.Patients in bupropion group received the treatment with bupropion and those in escitalopram group with escitalopram.Treatment course was 8weeks in both groups.Treatment effects were evaluated by Hamilton Depression Scale（HAMD）and Global Assessment Scale（GAS）,and the level of treatment effects were determined by the reducing score rate of HAMD.Treatment Emergent Symptom Scale（TESS）was used to evaluate the safety.Results Eighty-seven patients completed this study,with 43 patients in bupropion group and 44 patients in escitalopram group.At the end of the 8th week,the scores of HAMD were lower than those at baseline in both two groups（P〈0.01）,and the scores of GAS were higher than before（P〈0.01）.However,there were no significant differences in the scores of HAMD and GAS between the two groups（P〉0.05）.The effective rate of the bupropion group and the escitalopram group were 60%and 59%respectively without significant differences（P〉0.05）.Mild side effects were observed in both two groups and there were no significant differences for overall incidence（P〉0.05）.Conclusion Bupropion and escitalopram are both effective for elderly depression with equal efficacy and safety approximately.