米氮平与帕罗西汀治疗老年抑郁症的临床对照研究

目的比较米氮平和帕罗西汀治疗老年抑郁症的疗效及安全性。方法将70例住院老年抑郁症病人随机分为米氮平组和帕罗西汀组,各35例。米氮平起始剂量15mg·d-1,qn,1wk内加至30mg·d-1;帕罗西汀剂量为20mg·d-1,疗程均为6wk。以汉密尔顿抑郁量表(HAMD)和临床疗效总评量表(CGI)评定疗效,以抗抑郁药副反应量表(SERS)评定不良反应,分别在治疗前和治疗后2、4、6wk末评定一次。结果治疗前2组HAMD、病情严重程度(SI)评分无显著差异(P>0.05),治疗2、4、6wk末2组HAMD和SI评分与治疗前比较均显著下降(P<0.05或P<0.01)。治疗2wk末,HAMD和CGI评分2组间比较有非常显著差异(P<0.01);治疗4、6wk末,2组间HAMD、疗效总评(GI)和SI评分无显著差异(P>0.05),而疗效指数(EI)评分比较有显著差异(P<0.05)。治疗2、4、6wk末的SERS评分2组比较均有显著差异(P<0.05);帕罗西汀组躯体疲倦和性功能障碍发生多于米氮平组(P<0.05,P<0.01),而米氮平组发生嗜睡较多(P<0.05)。结论米氮平与帕罗西汀治疗老年抑郁症均有较好疗效,米氮平起效较快、不良反应较轻。

A clinical control study of mirtazapine vs.paroxetine in treatment of senile depression

AIM To compare the efficacy and safety of mirtazapine and paroxetine in the treatment of senile depression.METHODS Seventy senile inpatients with depression were randomly divided into miratazapine group(n=35) and paroxetine group(n=35).In the 6-week treatment,the dose of miratazapine was 15 mg,qn,and was added to 30 mg·d-1 in 1 week,and the dose of paroxetine was 20 mg·d-1.The Hamilton depression scale(HAMD) and clinical global impressions(CGI) were used to assess the therapeutic efficacy,and the rating scale for side effects(SERS) was used to evaluate the adverse reactions before and 2,4,and 6 weeks after the treatment.RESULTS The scores of HAMD and severty of illness(SI) before treatment had no significantly difference between the two groups(P > 0.05),and they decreased significantly(P < 0.05 or P < 0.01) compared with pre-treatment in both groups at the end of wk 2,4,and 6.The scores of HAMD and CGI had significantly difference(P < 0.01) between the two groups at the end of wk 2;at the end of wk 4 and 6,the scores of HAMD,SI,and global improvement(GI) had no significant difference between the two groups(P > 0.05),but the scores of efficacy index(EI) were significantly different(P < 0.05).The scores of SERS had significant difference(P < 0.05) between the two groups during the treatment.The patients with body weariness and sexual dysfunction in the paroxetine group were more than those in the miratazapine group(P < 0.05,P < 0.01),and the patients with lethargy were more in the miratazapine group(P < 0.05) .CONCLUSION Both miratazapine and paroxetine have good efficacy for senile depression,but miratazapine takes effect more quickly,and with mild adverse reactions.