Objective To study the efficacy and safety of escitalopram and paroxetine for patients with first-episode climacteric depression. Methods A 8-week double-blind study was conducted, including 70 female patients suffering from climacteric first-episode depression. Subjects were randomly assigned to either escitalopram ( n = 35 ) or paroxetine ( n = 35 ). All subjects were evaluated with Hamilton Rating Scale for Depression ( HAMD- 17) , Hamilton Rating Scale for Anxiety ( HAMA), and Treatment Emergent Symptom scale (TESS) at baseline, 1,2,3,4,6,8 weeks after treatment. The study lasted for 8 weeks. Results The response rates between two groups (escitalopram 88.23% paroxetine 79.41% ) were similar. Each group had a lost case. There were significant differences on the scores of HAMD between the tow groups at the 1st and 2nd weeks, and HAMA at the 1st week after treatment. Escitalopram group was significantly lower than paroxetine group in sleepiness, dry mouth, tremor.Conclusion Escitalopram has rapid response, strong anti-depressive effect in female climacteric first-episode patients.%目的 观察艾司西酞普兰对女性更年期首发抑郁症的治疗效果和药物不良反应.方法 将符合人组标准的70例患者采用随机数字表分成2组各35例,艾司西酞普兰组患者每天20:00服用艾司西酞普兰10 mg/d,1次/d;帕罗西汀组患者每天20:00服用帕罗西汀20 mg/d,1次/d.睡眠困难者可合并服用阿普唑仑0.8 mg,禁用其他抗抑郁药、抗精神病药和电休克等治疗.分别于治疗前和治疗后1、2、3、4、6、8周采用汉密尔顿抑郁量表(HAMD-17)和汉密尔顿焦虑量表(HAMA)评定严重程度和疗效,采用药物不良反应量表评定药物不良反应.结果 艾司西酞普兰组痊愈23例,好转7例,无效4例,因药物不良反应脱失1例,有效30例(88.23%),帕罗西汀组痊愈18例,好转9例,无效7例,因药物不良反应脱失1例,有效27例(79.41%).2组总疗效差异无统计学意义(X2=1.48,P>0.05).于治疗第1、2周末评定艾司西酞普兰组HAMD-17总分明显低于帕罗西汀组(P<0.05或P<0.01),从第3周末评定至第8周末评定2组显差异无统计学意义(P>0.05).HAMA总分第1周末艾司西酞普兰组明显低于帕罗西汀组(P<0.05),从第2周后差异无统计学意义(P>0.05).艾司西酞普兰组的嗜睡、口干、震颤等药物不良反应明显低于帕罗西汀组(P<0.05).结论 艾司西酞普兰起效快、作用强、药物不良反应少,对更年期妇女抑郁症有较好的疗效和安全性.
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