阿戈美拉汀与艾司西酞普兰治疗首发抑郁症的随机对照研究

A randomized controlledtrial about the treatment of first-episode depression by agomelatine and escitalopram

目的探讨阿戈美拉汀与艾司西酞普兰治疗首发抑郁症的临床疗效及其安全性。方法60例首发抑郁症患者,随机分为研究组和对照组,各30例。对照组单独用艾司西酞普兰治疗,研究组单独用阿戈美拉汀治疗,疗程8周。采用汉密尔顿抑郁量表-17(HAMD-17)和副作用量表(TESS)评价临床疗效及不良反应,根据两组患者的HAMD评分变化比较临床疗效、TESS评分比较不良反应的差异。结果对照组服药1周后HAMD评分与服药前相比,差异无统计学意义,但是服药2、4、8周后与服药前相比,差异均有显著意义;研究组治疗后的HAMD评分与治疗前相比,差异都有统计学意义。结论在服药4周后,艾司西酞普兰的临床疗效优于阿戈美拉汀,随着服药时间的延长,在服药8周后,阿戈美拉汀与艾司西酞普兰的临床效果相当,但是阿戈美拉汀起效较快,在服药1周左右起效,而艾司西酞普兰起效则需要2周。两种药物的不良反应少,安全性均较高。

Objective To explore the clinical efficacy and safety of agomelatine and escitalopram used for the treatment of first-episode depression.Methods Sixty patients with first-episode depression were randomly divided into the research group and control group,and each group had 30 patients.The control group was treated with escitalopram,and the research group was treated with agomelatine for 8 weeks.The Hamilton depression rating scale-17(HAMD-17)and side effect scale(TESS)were used to evaluate the clinical efficacy and adverse reactions.The difference of clinical efficacy was compared according to HAMD-17 scores of two groups and the difference of adverse reactions was compared according to TESS scores of two groups.Results There was no statistically significant difference between the HAMD-17 scores of control group after treatment of 1 week and that before the treatment.The differences among the HAMD-17 scores of control group after treatment of 2,4,8 weeks and that before the treatment were significant.The differences were significant among the HAMD-17 scores of research group after treatment and that before the treatment.Conclusion The effect of escitalopram was better than that of agomelatine after treatment of 4 weeks.With the extension of time,the effect between escitalopram and agomelatine was similar after treatment of 8 weeks,but agomelatine had a rapid onset of effect,around 1 week,and escitalopram needs 2 weeks.Both drugs had fewer adverse reactions and higher safety.