瑞波西汀与西酞普兰治疗老年抑郁症的对照研究

目的评价瑞波西汀治疗首发老年抑郁症的疗效和安全性。方法采用随机、单盲、平行对照方法。受试者分别口服瑞波西汀胶囊8mg/d（4mg/d起,周增至治疗量）或西酞普兰40mg/d（20mg/d起,周增11至治疗量）。采用HAMD、HAMA、CGI及TESS评定疗效及不良反应。结果共搜集符合入组标准的老年抑郁症80例,其中瑞波西汀组40例（试验组）,因药物不良反应脱落1例,因其他原因中途退出1例,实际完成38例。西酞普兰组40例（对照组）。经治疗6周后,瑞波西汀组HAMD、HAMA总分明显下降,与治疗基线相比差异有统计学意义（P〈0.01）,但两组间相比差异则无统计学意义（P〉0.05）;瑞波西汀组有效率（HAMD减分率≥50%）为76.3%,西酞普兰组为77.5%,两组间相比差异无统计学意义（P〉0.05）;临床治愈率（HAMD、HAMA总分≤8）瑞波西汀组为57.9%,西酞普兰组为57.5%,两组间差异无统计学意义（P〉0.05）;两组间CGI评分差异亦无统计学意义。安全性分析显示,两组不良反应的症状和发生率相比差异均无统计学意义。结论瑞波西汀治疗首发老年期抑郁症的疗效与西酞普兰相当,安全性高,不良反应较少,是药物治疗老年抑郁症的新选择。

A control study of reboxetine vs citalopram in the treatment of senile depression

Objective To evaluate the efficacy and safety of reboxetine in treatment of first-onset of senile depressive disorder.Methods A randomized,single blind parallel clinical trial was performed in which 80 patients with first-onset of senile depressive disorder were assigned to receive reboxetine capsule 8 mg/d(start at 4mg/d,increasing to 8mg/d in a week) or citalopram tablet 40m/d(start at 20mg/d,increasing to 40mg/d in a week).The efficacy of both treatment groups was evaluated based on the Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA) and clinical general impression scale(CGI).The drug safety was evaluated based on laborator data and vital signs.Results Of the total 80 patients who met the inclusion criteria were assigned to receive reboxetine(trial group,n=38)or citalopram(control group,n=40).After treatment for 42 days,at the end of therapy,the scores of HAMD,HAMA and CGI in the two groups were significantly reduced compared with the baseline in both groups(P<0.01).However,there was no significant difference between the two groups(P>0.05).The effective rate in the trial group was 76.3%(HAMD score reduction rate≥50%)versus 77.5% in the control group.The P value showed no statistical difference between the two groups(P>0.05).There were no statistical differences between the two groups in cure rate(HAMD and HAMA total scores≤8)(reboxetine group 57.9% vs citalopram 57.5%),CGI score and safety(symptoms and incidence of adverse drug reatctions).Conclusion Reboxetine,like citalopram,has been proved in efficacy and safety and less side effects in the treatment of first-onset of senile depressive disorder.It provides a new choice for treatment of senile depression