艾司西酞普兰与氟西汀治疗老年抑郁症的临床疗效比较

目的探讨艾司西酞普兰对老年抑郁症患者的疗效和安全性。方法将60例符合CCMD-3抑郁发作的老年抑郁症患者随机分为艾司西酞普兰组（艾司西酞普兰10—20mg·d^-1）和氟西汀组（氟西汀20—40mg·d^-1），疗效采用汉密尔顿抑郁量表（啪）评定，不良反应和安全性用TESS和实验室检查评定。共观察6周。结果艾司西酞普兰组显效率和治愈率分别为70．4％和44．5％，氟西汀组为69．2％和42．3％，两组比较差异无统计学意义。但艾司西酞普兰组在l周末Hh／VID评分与治疗前比较即有明显下降，且2组间差异有统计学意义（P〈0．05）。艾司西酞普兰组主要不良反应有食欲下降、恶心、头晕各3例次（10％），失眠、口干、心悸各2例次（6．7％），便秘、嗜睡各1例次（3．3％），与氟西汀组相比无统计学意义。结论艾司西酞普兰治疗老年抑郁症患者显效快，疗效和不良反应与氟西汀相似。

Comparison of clinical efficacy between escitalopram and fluoxetine in treatment of elderly depression

AIM To study the effcacy and safety of escitalopram in the treatment of elderly depression. METHODS This was a randomized, open-label, 6-week flexible dose study. Sixty patients were diagnosed as elderly depression based on Chinese classification and diagnostic criteria for mental disorders. The patients were randomly assigned to escitalopram treatment group with escitalopram 10- 20 mg· d^-1（ n = 30） and fluoxetine treatment group with fluoxetine 20- 40mg· d^-1（ n = 30）. Chnical effectiveness was evaluated with Hamilton depression scale （HAMD） , and adverse drug reactions and safety were assessed with treatment emergent symptom scale （ TESS ）and by laboratory examination. RESULTS The response rate and remission rate were 70. 4% and 44.5% for escitalopram treatment group and were 69.28% and 42.3% for fluoxetine treatment group,respectively. There was no statistically significant difference between 2 groups for both rates. But the HAMD score of escitalopram treatment group at the end of one week significantly de- creased compared with that before treatment, and statistical difference existed between 2 groups （ P 〈 0. 05）. The main adverse drug reactions of escitalopram treatment group were lack of appetite, nausea, dizziness（ each 3 patients, 10% ）, and sleepless, dry mouth, palpitation （each 2 patients, 6.7 % ）, and constipation, lethargy（ each 1 patients, 3.3 % ）, with no statistically significant difference compared with fluoxetine treatment group. CONCLUSION Escitalopram is more effective, while the efficacy and the adverse drug reactions are similar to fluoxetine.