比较米氮平与氟西汀治疗老年抑郁症的疗效和副反应

目的:比较抗抑郁药米氮平与氟西汀改善老年抑郁症的作用及不良反应。方法:老年抑郁症患者64例,随机分为2组各32例,A组患者晚上口服米氮平片15mg,2-3周内加至30mg;B组早上口服氟西汀片10mg,2-3周内加至20mg,均治疗6周。治疗前和治疗1、2、4、6周末时分别采用汉密尔顿抑郁量表(HAMD)、副反应量表(TESS)评定疗效和不良反应。结果:HAMD减分率在治疗第1周时A组明显低于B组(P<0.01);第2周末时2组比较差异无显著性意义;6周后,A组和B组有效率及治愈率无明显差别,分别为85.2%、53%与84.4%、49%。TESS评分比较,A组轻于B组。结论:米氮平与氟西汀对老年抑郁症患者均有肯定疗效,且副作用小;但米氮平起效更快,副反应更轻微,更能提高老年患者接受治疗的依从性。

Curative Effectiveness and Side Effects of Fluoxetine vs Remeron in the Treatment of the Senile Depression

Objective:To study the effectiveness and side effects of Fluoxetine vs Remeron treating the senile depression.Methods:Sixty-four old depressive patients which were diagnosed as having CCMD-3 were randomly divided into Fluoxetine group with 32 patients and Remeron group with 32 patients.The patients were treated for 6 weeks.The HAMD and the TESS were used to assess the effect and safety before and 1,2,4 and 6 weeks after treatment.Results:(1) The scores of HAMD in Remeron group were significantly lower than in Fluoxetine group one week after treatment(P<0.01).There was significant difference in scores of HAMD between two groups after treatment for 2 weeks.(2) After treatment for 6 weeks,the effective rate in Remeron group and Fluoxetine group was 85.21% and 84.39% respectively,and the healing rate was 53% and 49% respectively with the difference being not significant between the two groups.(3) The side effect in Remeron group was milder than in Fluoxetine group.Conclusion:Fluoxetine and Remeron were more effective and safe to cure the senile depression.But the curative effects that Remeron exerted were quicker than Fluoxetine,and the side effect of Remeron was milder.Remeron was superior to Fluoxetine on compliance for the senile depression.