艾司西酞普兰治疗焦虑症、抑郁症的疗效观察

目的 观察艾司西酞普兰治疗焦虑症及抑郁症的疗效.方法 对焦虑症和抑郁症患者各50例(分别为焦虑症组和抑郁症组)进行艾司西酞普兰6周开放性治疗,剂量10～15mg/d.治疗后比较2组疗效及汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)评分,并观察不良反应.结果 焦虑症组总有效率为79.6%,抑郁症组总有效率为82.0%,2组差异无统计学意义(P＞0.05).2组治疗后HAMD、HAMA评分均改善(P＜0.01),且2组间治疗前后HAMD、HAMA评分比较差异无统计学意义(P＞0.05).2组不良反应发生率比较差异无统计学意义(P＞0 05).且不良反应轻微.结论 艾司西酞普兰治疗焦虑症与抑郁症同样有效,可视为一种抗焦虑症的有效药物.     

艾司西酞普兰与帕罗西汀治疗老年抑郁症的对照研究

目的 探讨艾司西酞普兰与帕罗西汀治疗老年抑郁症的疗效及安全性.方法 80例老年抑郁症患者分为艾司西酞普兰组和帕罗西汀组,每组40例,治疗6周.采用汉密尔顿抑郁量表（HAMD-17）汉密尔顿焦虑量表（HAMA）评定疗效;采用治疗中出现的症状量表（TESS）及实验室检查评定安全性.结果 治疗6周末2组总体疗效差异无统计学意义 （P＞0.05）;治疗1～2周,艾司西酞普兰组显效快.不良反应艾司西酞普兰组发生率较帕罗西汀组显著降低（P＜0.05）.结论 艾司西酞普兰和帕罗西汀治疗抑郁症疗效确切,艾司西酞普兰起效快,不良反应少,耐受性好,可作为老年抑郁症的首选药物.     

艾司西酞普兰与氟西汀治疗老年抑郁症的疗效与安全性对比观察

目的对比分析艾司西酞普兰与氟西汀治疗老年抑郁症的临床疗效与安全性,探讨老年抑郁症的合理治疗方法。方法将确诊为抑郁症的104例老年患者随机分为艾司西酞普兰组和氟西汀组,每组各52例,分别进行2个月的治疗,治疗前及治疗后2、4、8周进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、不良反应量表(TESS)评定两种药物的临床疗效与安全性。结果艾司西酞普兰组的总有效率为92.16%,氟西汀组的总有效率为82.15%,两组疗效比较差异无统计学意义(P>0.05);艾司西酞普兰组和氟西汀组的患者在治疗2周后的HAMD和HAMA评分差异有统计学意义,艾司西酞普兰组明显低于氟西汀组;而且艾司西酞普兰组治疗4、6周后HAMD评分也明显低于氟西汀组;氟西汀组出现乏力、便秘、恶心比例明显高于艾司西酞普兰组,差异有统计学意义。结论艾司西酞普兰较氟西汀更适合于老年期抑郁的治疗,抑郁和焦虑症状评分改善的时间更早,且安全性更好,可作为治疗老年抑郁症的首选药物。     

艾司西酞普兰治疗抑郁症伴焦虑37例

目的探讨艾司西酞普兰治疗抑郁症伴焦虑的疗效和安全性。方法将74例抑郁症患者随机均分成两组,治疗组予艾司西酞普兰治疗,对照组予文拉法辛治疗,疗程均为6周,采用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）进行疗效评定和不良反应评估。结果治疗6周后两组HAMD和HAMA分值明显低于治疗前,但两组间无显著性差异;治疗组显效率和有效率分别为64.85%和83.78%,对照组分别为63.89%和83.33%,组间比较均无统计学意义;两组间不良反应亦无显著性差异。结论艾司西酞普兰起效快、不良反应少,可作为抑郁症治疗的一线药物。     

艾司西酞普兰联合认知行为疗法治疗焦虑症30例

目的 观察艾司西酞普兰合并认知行为疗法治疗焦虑症的临床疗效.方法 将60例焦虑症患者随机分为两组,研究组(30例)采用艾司西酞普兰合并认知行为疗法治疗,对照组(30例)单用艾司西酞普兰治疗,均治疗6周.于治疗前后分别用汉密尔顿焦虑量表(HAMA)、临床疗效总评量表中疗效总评分量表(CGI-CI)评定疗效,半年后随访.结果 治疗2周末,两组HAMA评分分别与治疗前比较,有非常显著性差异(P<0.01);治疗6周末,研究组的HAMA和CGI-GI评分下降较对照组更明显,差异具有统计学意义(P<0.05);6个月后,CGI-GI评分研究组与对照组相比,差异具有统计学意叉,研究组低于对照组(P<0.05).结论 艾司西酞普兰与认知行为疗法联用后不仅抗焦虑作用良好,而且能有效延缓病情复发,且药物不良反应少.     

艾司西酞普兰治疗焦虑症、抑郁症的疗效观察

目的观察艾司西酞普兰治疗焦虑症及抑郁症的疗效。方法对焦虑症和抑郁症患者各50例(分别为焦虑症组和抑郁症组)进行艾司西酞普兰6周开放性治疗,剂量10~15mg/d。治疗后比较2组疗效及汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)评分,并观察不良反应。结果焦虑症组总有效率为79.6%,抑郁症组总有效率为82.0%,2组差异无统计学意义(P>0.05)。2组治疗后HAMD、HAMA评分均改善(P<0.01),且2组间治疗前后HAMD、HAMA评分比较差异无统计学意义(P>0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。且不良反应轻微。结论艾司西酞普兰治疗焦虑症与抑郁症同样有效,可视为一种抗焦虑症的有效药物。     

79例国产艾司西酞普兰与进口艾司西酞普兰治疗抑郁症的临床研究

目的评价国产艾司西酞普兰(百洛特)与进口艾司西酞普兰(来士普)治疗抑郁症的疗效及安全性。方法将80例住院抑郁症患者随机分为国产艾司西酞普兰组(n=40)和进口艾司西酞普兰组(n=40)为期6周的双盲对照实验。分别在治疗治疗1、2、4、6周末以汉密尔顿抑郁量表(Hamilton depression scales,HAMD)评定疗效,以治疗不良反应量表(Treatment emergent symptom scale,TESS)评定不良反应。结果共计71例患者(国产艾司西酞普兰组36例,进口艾司西酞普兰例35例)完成为期6周的治疗。国产艾司西酞普兰(百洛特)组和进口艾司西酞普兰(来士普)组总显效率分别为83.3%和85.7%,差异无统计学意义(P>0.05)。两组不良反应率分别为国产组22.2%,进口组19.4%,无显著差异(P>0.05)。在治疗1周后HAMD评分与基线分比较均有显著下降(P<0.05)。随着治疗的持续,各个时相点评分均显著下降(P<0.01)。在治疗前基线水平和治疗第1、2、4、6周末,组间HAMD减分率比较差异无显著性(P>0.05)。结论国产艾司西酞普兰(百洛特)与进口艾司西酞普兰(来士普)治疗抑郁症均有较好疗效,疗效相当,不良反应较轻。国产艾司西酞普兰成本效应更好,适合于抑郁症患者。     

艾司西酞普兰联合丁螺环酮治疗伴躯体症状抑郁症的临床研究

目的探讨艾司西酞普兰联合丁螺环酮治疗伴躯体症状抑郁症的临床效果及不良反应。方法将120例抑郁症患者随机分为研究组和对照组,每组60例,分别给予艾司西酞普兰联合丁螺环酮治疗、艾司西酞普兰并安慰剂治疗,共治疗8周,采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、不良反应量表（TESS）评定疗效及不良反应。结果治疗后两组HAMD、HAMA评分均显著降低,前后差异有统计学意义（P〈0．05）;治疗第2、4、6、8周研究组HAMD、HAMA评分低于对照组（P〈0．05）;两组不良反应差异无统计学意义（P〉0．05）。结论艾司西酞普兰合并丁螺环酮治疗伴躯体症状抑郁症能明显增强总体疗效,且不增加不良反应。     

艾司西酞普兰对广泛性焦虑患者的疗效观察

目的观察艾司西酞普兰对广泛性焦虑患者疗效及不良反应的影响。方法将100例广泛性焦虑患者随机分为实验组与对照组,每组50例。实验组予艾司西酞普兰片口服15mg／d,对照组予艾司西酞普兰模拟剂15mg／d,两组进行6周的治疗,采用汉密尔顿焦虑量表（HAMA）评价疗效,抗抑郁药副反应评定量表（SERS）评定艾司西酞普兰的不良反应。结果与对照组比较,治疗后实验组HAMA评分明显下降（P〈0．01）;实验组治疗的总有效率为70％（35例）,对照组为30％（15例）,两组比较差异有统计学意义（P〈0．01）。结论艾司西酞普兰对广泛性焦虑患者的疗效显著,安全性高。     

艾司西酞普兰治疗抑郁症有效性和安全性研究

目的 探究艾斯西酞普兰对抑郁症患者的治疗效果以及安全性.方法 选取2015年3月~2016年9月在我院接受治疗的110例抑郁症患者,随机均分成观察组和对照组,观察组患者服用艾司西酞普兰治疗,对照组患者服用西酞普兰治疗.对治疗后两组患者的汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)以及不良反应发生情况进行分析比较.结果 治疗后观察组患者的HAMA评分以及HAMD评分的下降幅度与对照组患者相比没有显著性差异(P>0.05);观察组的治疗有效率为78.18%,对照组的有效率为69.09%,两组之间无显著差异(P>0.05);观察组的不良反应发生率为27.27%明显低于对照组的38.18%,有明显差异(P<0.05).结论 艾司西酞普兰与经典药物西酞普兰对抑郁症患者均能起到较为显著的治疗效果,但艾司西酞普兰的安全性更高,值得在临床广泛推广应用.     

Escitalopram (10-20 mg/day) is effective and well tolerated in a placebo-controlled study in depression in primary care

Escitalopram was compared to placebo in moderately to severely depressed patients in primary care with citalopram as the active reference. Patients were randomized to receive flexible doses of 10-20 mg/day escitalopram (n=155), 20-40 mg/day citalopram (n=160), or placebo (n=154) over an 8-week double-blind period. The primary efficacy parameter was the change from baseline to last assessment in the Montgomery-Asberg Depression Rating Scale total score. Escitalopram produced a statistically significant therapeutic difference of 2.9 points (P=0.002) compared to placebo, and escitalopram was consistently and statistically significantly more efficacious than placebo from week 1 onwards. Analysis of Clinical Global Impression-Severity and Clinical Global Impression-Improvement confirmed the primary efficacy results. By week 8, significantly more patients had responded to treatment with escitalopram than with citalopram (P=0.021) or placebo (P=0.009). Escitalopram was as well tolerated as citalopram and had a similar adverse event profile. Both escitalopram- and citalopram-treated patients had placebo-level adverse event withdrawal rates (3% and 4%, respectively). This study demonstrates the consistent antidepressant efficacy and excellent tolerability of escitalopram 10-20 mg/day in primary care patients with major depressive disorder.     

Evidence based review of escitalopram in treating major depressive disorder in primary care

The study aimed to summarize clinical data for escitalopram in the treatment of major depressive disorder in primary care. Medline, Embase and Cochrane databases were searched for randomized controlled trials of escitalopram (10-20 mg/day for 8 weeks) versus other antidepressants in therapeutic doses or placebo. Patients were required to have had moderate/severe depression, with Montgomery-Asberg Depression Rating Scale (MADRS) scores recorded at baseline and 8 weeks. Outcomes examined were remission rates (MADRS/=50% decrease from baseline in MADRS at week 8). Data were combined using a random effects meta-analytic model. Of the 15 studies identified, 11 were rejected (five not primary care, four duplicate reports, one lacked 8-week MADRS scores, one not depression) and four were accepted (n=1472 patients). The four studies had nine arms, four for escitalopram (n=654), two for citalopram (n=333), one for venlafaxine-XR (n=142) and two for placebo (n=343). Remission rates for escitalopram were superior to placebo (48.7% versus 37.6%, P=0.003) and citalopram (52.8% versus 43.5%, P=0.003) but similar to venlafaxine-XR (P=0.97). Response rates were superior to placebo (48.7% versus 43.1%, P<0.001) and citalopram (62.5% versus 49.5%, P=0.001) but not venlafaxine-XR (P=0.52). Adverse events were comparable among active drugs (P<0.05). Remission rates for escitalopram were superior to placebo (48.7% versus 37.6%, P=0.003) and citalopram (52.8% versus 43.5%, P=0.003) but similar to venlafaxine-XR (P=0.97). Response rates were superior to placebo (48.7% versus 43.1%, P<0.001) and citalopram (62.5% versus 49.5%, P=0.001) but not venlafaxine-XR (P=0.52). Adverse events were comparable among active drugs (P>0.05). Remission and response rates of escitalopram in primary care are clinically superior to placebo and citalopram, but similar to venlafaxine-XR. Further head-to-head trials are warranted to verify these findings. A pharmacoeconomic analysis is also required to determine whether these clinical advantages for the patients translate into economic advantages for the health care system.     

Efficacy and safety of escitalopram versus citalopram in major depressive disorder: a 6-week, multicenter, randomized, double-blind, flexible-dose study

Rationale

S-citalopram (escitalopram) is the very active moiety of citalopram. It has been shown in many studies to be an effective and safe antidepressant for treating major depressive disorder (MDD).

Objective

The aim of our study was to compare the efficacy and safety of escitalopram vs citalopram in Chinese MDD patients.

Methods

In the double-blind study, 240 MDD patients were randomly assigned to treatment for 6 weeks either with escitalopram (10?C20?mg/d) or citalopram (20?C40?mg/d). The primary efficacy measurement was the change of 17-item Hamilton Depression Rating Scale (HAMD-17) total score from baseline to the end of study. The secondary efficacy measurements were response and remission rates. The adverse events (AEs) were recorded by the investigator.

Results

Two hundred and three (85%) patients completed the trial. The average dose was 13.9?mg/d in the escitalopram group and 27.6?mg/d in the citalopram group. No significant differences were found between the two groups in the change in HAMD-17 total score, response, and remission rate. These results were similar in severe MDD patients. No significant differences were found between the two groups in AEs. No serious AEs were observed in this study.

Conclusions

The study suggests that escitalopram 10?C20?mg/d are as effective and safe as citalopram 20?C40?mg/d in the short-term treatment for Chinese MDD patients.     

Prospective, multicentre, randomized, double-blind study of the efficacy of escitalopram versus citalopram in outpatient treatment of major depressive disorder

Pre-clinical studies, active-control clinical trials and meta-analyses indicate that escitalopram (S-citalopram) might be more effective than citalopram, the racemic mixture of S- and R-citalopram. The present study aimed to confirm the superior efficacy of escitalopram over citalopram. A double-blind, randomized clinical trial was performed in which general practitioners and psychiatrists compared fixed doses of escitalopram (20 mg/day) with citalopram (40 mg/day) over 8 weeks in outpatients with major depressive disorder (MDD) [baseline Montgomery-Asberg Depression Rating Scale (MADRS) score > or =30]. Primary efficacy parameter was change from baseline to last assessment in the MADRS total score. Out of 138 (aged 44.1+/-10.9 years; initial MADRS score 36.3+/-4.8) and 142 (aged 46.2+/-11.1 years; initial MADRS score 35.7+/-4.4) evaluable patients who were randomized to escitalopram and citalopram, respectively, six and 15 withdrew prematurely (P=0.05). The MADRS score decreased more in the escitalopram than in the citalopram arm (-22.4+/-12.9 versus -20.3+/-12.7; P<0.05). There were more treatment responders with escitalopram (76.1%) than with citalopram (61.3%, P<0.01). Adjusted remitter rates were 56.1% and 43.6%, respectively (P<0.05). Tolerability was similar in both groups. This randomized double-blind trial confirms that escitalopram has a superior effect to citalopram in MDD.     

Prevention of relapse in generalized anxiety disorder by escitalopram treatment

Escitalopram has demonstrated a robust and dose-dependent efficacy in the treatment of generalized anxiety disorder (GAD) for up to 3 months. In the present study, the efficacy and tolerability of escitalopram in the prevention of relapse in GAD was investigated. A total of 491 patients with a primary diagnosis of GAD and a Hamilton Anxiety (HAMA) total score>or=20 received 12 wk of open-label treatment with a fixed dose of escitalopram (20 mg/d). Of these, 375 patients responded (HAMA total scoreor=15, or lack of efficacy, as judged by the investigator. The results of the primary analysis showed a clear beneficial effect of escitalopram relative to placebo on the time to relapse of GAD (log-rank test, p<0.001). The risk of relapse was 4.04 times higher for placebo-treated patients than for escitalopram-treated patients; the proportion of patients who relapsed was statistically significantly higher in the placebo group (56%) than in the escitalopram group (19%) (p<0.001). Escitalopram was well tolerated and 7% of the escitalopram-treated patients withdrew due to adverse events, vs. 8% of the placebo patients. The incidence of discontinuation symptoms with escitalopram during tapered withdrawal was low; the symptoms primarily being dizziness (10-12%), nervousness (2-6%), and insomnia (2-6%). Escitalopram 20 mg/d significantly reduced the risk of relapse and was well tolerated in patients with GAD.     

A randomized, double-blind, 24-week study of escitalopram (10 mg/day) versus citalopram (20 mg/day) in primary care patients with major depressive disorder

OBJECTIVE: A randomized, double-blind, 24-week-fixed-dose study comparing the efficacy and safety of escitalopram to that of citalopram was safety was conducted in primary care patients with moderate to severe major depressive disorder (MDD). RESEARCH DESIGN AND METHODS: This was a randomized, double-blind, 24-week fixeddose study. Patients were randomly assigned to treatment with escitalopram 10 mg/day (n = 175) or citalopram 20 mg/day (n = 182). Clinical response was evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS) and Clinical Global Impression-Severity (CGI-S) scale. The prospectively defined primary parameter of antidepressant efficacy was the change from baseline in the mean MADRS total score during the 24 weeks of double-blind treatment, using a repeated measures analysis of variance to compare the treatment groups over all assessment points simultaneously. RESULTS: Based on the primary parameter, escitalopram was at least as efficacious as citalopram. Based on the prospectively defined secondary parameter, mean change from baseline in the CGI-S score, escitalopram was statistically significantly superior to citalopram at Week 24. The importance of long-term treatment could be demonstrated, in that more than half (55% and 51%) of the patients who had not responded by Week 8 achieved remission by Week 24. Both escitalopram and citalopram were safe and well tolerated in acute and long-term treatment, and the overall adverse event profiles for the two drugs were similar. For the intent-to-treat population, there were statistically significantly fewer withdrawals in the escitalopram group than in the citalopram group, particularly after Week 8. CONCLUSION: Patients with MDD responded well to long-term treatment with either escitalopram or citalopram. This study demonstrated the importance of extending treatment of depression beyond 8 weeks.     

艾司西酞普兰与氟西汀治疗抑郁症对照研究

目的比较艾司西酞普兰与氟西汀治疗抑郁症的疗效和安全性。方法随机将77例符合CCMD-3抑郁发作的住院患者分为艾司西酞普兰组和氟西汀组,艾司西酞普兰组剂量10～20mg／d,氟西汀组20～40mg／d,疗程6周。疗效采取汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定,不良反应和安全性用TESS和实验室检查评定。结果两组总体疗效相当,艾司西酞普兰组有效率为87．2％,治愈率为48．7％,氟西汀组有效率为86．8％,治愈率4为7．4％,两组疗效比较差异无显著性。但1周末时HAMD评分及减分率两组间差异有显著性,说明艾司西酞普兰起效快;艾司西酞普兰组不良反应发生率明显少于氟西汀组,差异有统计学意义。结论艾司西酞普兰是安全、有效的抗抑郁药。     

西酞普兰对恶性肿瘤患者抑郁症状的随机双盲对照研究

目的以随机双盲对照研究明确西酞普兰在肿瘤患者伴随抑郁症的疗效和安全性。方法188例恶性肿瘤伴随抑郁症患者随机分为两组,分别给以西酞普兰和安慰剂治疗6周。采用汉密尔顿抑郁量表（HAMD一17）,汉密尔顿焦虑量表（HAMA）于治疗前和治疗1、2、4、6周末分别评定疗效。结果西酞普兰组总有效率62．22％,治疗后HAMD和HAMA评分均较治疗前下降,同安慰剂对照组相比差异有显著性（p〈0．05）。两组不良反应发生率轻微,比较差异无显著性（p〉0．05）。结论西酞普兰治疗肿瘤患者伴随抑郁症疗效确切,不良反应轻微。     

Escitalopram (S‐Enantiomer of Citalopram): Clinical Efficacy and Onset of Action Predicted from a Rat Model

Abstract: Escitalopram is the active S‐enantiomer of citalopram. In a chronic mild stress model of depression in rats, treatments with both escitalopram and citalopram were effective; however, a faster time to onset of efficacy compared to vehicle treatment was observed for escitalopram‐treated (5 mg/kg/day) than for citalopram‐treated (10 mg/kg/day) rats at Week 1. To study the predictability of this observation in the clinic, we analysed 4‐week data from an 8‐week, double‐blind, randomised, placebo‐controlled, flexible‐dose study that compared escitalopram and citalopram to placebo in primary care patients with major depressive disorder (baseline Montgomery and Åsberg Depression Rating Scale (MADRS) scores ≥22 and ≤40). Since the flexible dosing started after Week 4, analysis of 4‐week data ensured that the patients received fixed doses of 10 mg/day escitalopram (155 patients), 20 mg/day citalopram (160 patients), or placebo (154 patients). The efficacy analysis showed a significantly superior therapeutic effect for escitalopram versus placebo from Week 1 onwards (observed cases) with an adjusted mean change in MADRS at Week 4 (last observation carried forward) of 2.7 points (P=0.002). By comparison, 20 mg/day citalopram did not demonstrate a statistically significant effect compared to placebo. Escitalopram was well tolerated with an adverse event profile similar to that of citalopram. The preclinical observation that escitalopram possesses a faster time to onset of efficacy than citalopram was also seen in primary care patients with major depressive disorder. Thus, escitalopram is efficacious in depression and the effect occurs earlier than for citalopram.     

Escitalopram (S-enantiomer of citalopram): clinical efficacy and onset of action predicted from a rat model

Escitalopram is the active S-enantiomer of citalopram. In a chronic mild stress model of depression in rats, treatments with both escitalopram and citalopram were effective; however, a faster time to onset of efficacy compared to vehicle treatment was observed for escitalopram-treated (5 mg/kg/day) than for citalopram-treated (10 mg/kg/day) rats at Week 1. To study the predictability of this observation in the clinic, we analysed 4-week data from an 8-week, double-blind, randomised, placebo-controlled, flexible-dose study that compared escitalopram and citalopram to placebo in primary care patients with major depressive disorder (baseline Montgomery and Asberg Depression Rating Scale (MADRS) scores > or =22 and < or =40). Since the flexible dosing started after Week 4, analysis of 4-week data ensured that the patients received fixed doses of 10 mg/day escitalopram (155 patients), 20 mg/day citalopram (160 patients), or placebo (154 patients). The efficacy analysis showed a significantly superior therapeutic effect for escitalopram versus placebo from Week 1 onwards (observed cases) with an adjusted mean change in MADRS at Week 4 (last observation carried forward) of 2.7 points (P=0.002). By comparison, 20 mg/day citalopram did not demonstrate a statistically significant effect compared to placebo. Escitalopram was well tolerated with an adverse event profile similar to that of citalopram. The preclinical observation that escitalopram possesses a faster time to onset of efficacy than citalopram was also seen in primary care patients with major depressive disorder. Thus, escitalopram is efficacious in depression and the effect occurs earlier than for citalopram.