比较舍曲林和氟伏沙明对老年重性抑郁症患者的治疗一项双盲、随机试验解读.docVIP

比较舍曲林和氟伏沙明对老年重性抑郁症患者的治疗一项双盲、随机试验 David Rossini, MD,* Alessandro Serretti, MD,* Linda Franchini, MD,* Laura Mandelli,* Enrico Smeraldi, MD,* Diana De Ronchi, MD,? 和Raffaella Zanardi, MD* 背景：重性抑郁症是老年人口中一种常见的精神障碍。已确定三环类抗抑郁药的有效性，但选择性5-羟色胺再摄取抑制剂似乎有类似的效果，且耐受性和安全性良好。由于缺乏有关氟伏沙明治疗老年抑郁患者的文献资料，本研究的目的是比较氟伏沙明和舍曲林治疗老年患者的有效性和耐受性。 方法：在双盲条件下，93例年龄大于59岁的住院患者，其符合《精神疾病诊断与统计手册》（第四版）中的重性抑郁发作标准，将患者随机分配到舍曲林组（每日150mg）或氟伏沙明组（每日200mg），共7周。临床反应定义为汉密尔顿抑郁量表评分减少到8或以下。 结果：研究结束时，舍曲林和氟伏沙明的应答率分别为55.6％（25/ 45）和71.8％（28/ 39。两个治疗组的最终应答率无显著差异（P = 0.12）。对汉密尔顿抑郁量表评分的重复测量方差分析表明，两个治疗组间的抑郁症状减少存在显著差异，氟伏沙明组显著减少（P = 0.007）。舍曲林和氟伏沙明的整体安全性较好，两者无差异。 结论：这项双盲试验的结果表明，舍曲林和氟伏沙明可能是治疗老年抑郁症的有效药物，且后者的反应速度更快。有必要采用安慰剂对照研究进一步证明这些结果。 Sertraline Versus Fluvoxamine in the Treatment of Elderly Patients With Major Depression A Double-blind, Randomized Trial David Rossini, MD,* Alessandro Serretti, MD,* Linda Franchini, MD,* Laura Mandelli,* Enrico Smeraldi, MD,* Diana De Ronchi, MD,y and Raffaella Zanardi, MD* Background: Major depression is a common psychiatric disorder in the elderly population. The efficacy of tricyclic antidepressants is well established, and selective serotonin reuptake inhibitors appear to have a similar effectiveness along with advantages in terms of tolerability and safety. Given the lack of literature data regarding fluvoxamine in the treatment of depressed elderly patients, the aim of the present study was to compare its efficacy and tolerability with those of sertraline in a sample of elderly patients. Methods: Under double-blind conditions, 93 hospitalized patients older than 59 years, who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for a major depressive episode, were randomly assigned to receive sertraline (150 mg daily) or fluvoxamine (200 mg daily) for 7 weeks. The clinical response was defined as a reduction on the Hamilton Rating Scale for Depression score to 8 or below. Results: At study completion, the response rates were 55.6%(25/45) and 71.8% (28/39) for