西酞普兰与度洛西汀治疗抑郁症的性别与年龄差异
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摘要
目的探讨西酞普兰与度洛西汀治疗抑郁症的性别与年龄差异。方法将207例抑郁症病人随机分为西酞普兰组(110例)和度洛西汀组(97例),分别给予西酞普兰和度洛西汀口服治疗6周,分别于治疗前及治疗1、2、4、6周末,采用汉密尔顿抑郁量表(HAMD)评定疗效。结果治疗后两组HAMD评分均较治疗前明显降低,差异有统计学意义(F=35.49、48.92,P<0.01);治疗前后两组间HAMD评分比较差异均无显著性(P>0.05)。两组男性病人治疗后HAMD评分变化差异均无统计学意义(P>0.05),西酞普兰组女性病人治疗4、6周末的HAMD评分变化大于度洛西汀组女性病人,差异有统计学意义(F=2.50、2.53,P<0.05)。西酞普兰组女性病人治疗后HAMD评分变化与年龄呈负相关(r=-0.25,P<0.05)。结论西酞普兰和度洛西汀总体抗抑郁治疗效果相当,西酞普兰治疗女性抑郁症病人效果优于度洛西汀,且对年轻女性病人疗效优于老年女性,而度洛西汀治疗抑郁症效果没有性别和年龄差异。
Objective To investigate the impacts of gender and age on the efficacy of citalopram and duloxetine for depression. Methods A total of 207 patients with depression were randomly divided into citalopram group(n=110)and duloxetine group(n=97).The two groups received oral administration of citalopram and duloxetine,respectively,for 6 weeks.The treatment outcomes were evaluated by the Hamilton Depression(HAMD)Scale before treatment and after 1,2,4,and 6 weeks of treatment. Results After treatment,the HAMD score was significantly reduced in both groups(F=35.49,48.92;P<0.05).There was no significant difference in the HAMD score before or after treatment between the two groups(P>0.05).For male patients,there was no significant difference in the change in the HAMD score after treatment between the two groups(P>0.05).For female patients,the changes in the HAMD score after 4 and 6 weeks of treatment were significantly greater in the citalopram group than in the duloxetine group(F=2.50,2.53;P<0.05).The change in the HAMD score after treatment was negatively correlated with age among the female patients in the citalopram group(r=-0.25,P<0.05). Conclusion The overall efficacy of citalopram and duloxetine is similar in the treatment of depression.Citalopram has superior antidepressant efficacy to duloxetine among female patients.Citalopram also achieves better antidepressant outcomes in young females than in elderly females.By contrast,gender and age have no impacts on the antidepressant efficacy of duloxetine.
Objective To investigate the impacts of gender and age on the efficacy of citalopram and duloxetine for depression. Methods A total of 207 patients with depression were randomly divided into citalopram group(n=110)and duloxetine group(n=97).The two groups received oral administration of citalopram and duloxetine,respectively,for 6 weeks.The treatment outcomes were evaluated by the Hamilton Depression(HAMD)Scale before treatment and after 1,2,4,and 6 weeks of treatment. Results After treatment,the HAMD score was significantly reduced in both groups(F=35.49,48.92;P<0.05).There was no significant difference in the HAMD score before or after treatment between the two groups(P>0.05).For male patients,there was no significant difference in the change in the HAMD score after treatment between the two groups(P>0.05).For female patients,the changes in the HAMD score after 4 and 6 weeks of treatment were significantly greater in the citalopram group than in the duloxetine group(F=2.50,2.53;P<0.05).The change in the HAMD score after treatment was negatively correlated with age among the female patients in the citalopram group(r=-0.25,P<0.05). Conclusion The overall efficacy of citalopram and duloxetine is similar in the treatment of depression.Citalopram has superior antidepressant efficacy to duloxetine among female patients.Citalopram also achieves better antidepressant outcomes in young females than in elderly females.By contrast,gender and age have no impacts on the antidepressant efficacy of duloxetine.
引文
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[12]FERNNDEZ-GUASTI A,OLIVARES-NAZARIO M,REYES R,et al.Sex and age differences in the antidepressantlike effect of fluoxetine in the forced swim test[J].Pharmacology Biochemistry and Behavior,2017,152:81-89.
[13]BANO S,AKHTER S,AFRIDI M I.Gender based response to fluoxetine hydrochloride medication in endogenous depression[J].Journal of the College of Physicians and SurgeonsPakistan:JCPSP,2004,14(3):161-165.
[14]WANG Ming,CHEN Qian,LI Mei,et al.Alarin-induced antidepressant-like effects and their relationship with hypothalamus-pituitary-adrenal axis activity and brain derived neurotrophic factor levels in mice[J].Peptides,2014,56(3):163-172.
[15]XING Yanli,HE Jie,HOU Jian,et al.Gender differences in CMS and the effects of antidepressant venlafaxine in rats[J].Neurochemistry International,2013,63(6):570-575.
[16]THASE M E,ENTSUAH R,CANTILLON M,et al.Relative antidepressant efficacy of venlafaxine and SSRIs:sex-age interactions[J].Journal of Women’s Health,2005,14(7):609-616.
[2]MORISHITA S,ARITA S.Differential effects of milnacipran,fluvoxamine and paroxetine for inhibited and agitated depression[J].European Psychiatry,2004,19(7):450-451.
[3]GARTLEHNER G,CHAPMAN A,STROBELBERGER M,et al.Differences in efficacy and safety of pharmaceutical treatments between men and women:an umbrella review[J].PloSOne,2010,5(7):e11895-e11904.
[4]周晓彬,纪新强,徐莉.PPMS 1.5统计软件的功能及其应用[J].青岛大学医学院学报,2009,45(1):91-93.
[5]HYDE J S,MEZULIS A H,ABRAMSON L Y.The ABCs of depression:integrating affective,biological,and cognitive models to explain the emergence of the gender difference in depression[J].Psychol Rev,2008,115(2):291-313.
[6]HU Yao,WU Danlian,LUO Chunxia,et al.Hippocampal nitric oxide contributes to sex difference in affective behaviors[J].Proc Natl Acad Sci USA,2012,109(35):14224-14229.
[7]HILL T D,NEEDHAM B L.Rethinking gender and mental health:a critical analysis of three propositions[J].Soc Sci Med,2013,92:83-91.
[8]KOKRAS N,ANTONIOU K,MIKAIL H G,et al.Forced swim test:What about females[J]?Neuropharmacology,2015,99:408-421.
[9]MARTENYI F,DOSSENBACH M,MRAZ K,et al.Gender differences in the efficacy of antidepressants with serotonergic or norepinephrinergic reuptake inhibition profile[J].Eur Neuropsychopharmacol,2001,11(3):227-232.
[10]YOUNG E A,KORNSTEIN S G,MARCUS S M,et al.Sex differences in response to citalopram:a STAR*D report[J].Journal of Psychiatric Research,2009,43(5):503-511.
[11]KORNSTEIN S G,SCHATZBERG A F,THASE M E,et al.Gender differences in treatment response to sertraline versus imipramine in chronic depression[J].Am J Psychiatry,2000,157(9):1445-1452.
[12]FERNNDEZ-GUASTI A,OLIVARES-NAZARIO M,REYES R,et al.Sex and age differences in the antidepressantlike effect of fluoxetine in the forced swim test[J].Pharmacology Biochemistry and Behavior,2017,152:81-89.
[13]BANO S,AKHTER S,AFRIDI M I.Gender based response to fluoxetine hydrochloride medication in endogenous depression[J].Journal of the College of Physicians and SurgeonsPakistan:JCPSP,2004,14(3):161-165.
[14]WANG Ming,CHEN Qian,LI Mei,et al.Alarin-induced antidepressant-like effects and their relationship with hypothalamus-pituitary-adrenal axis activity and brain derived neurotrophic factor levels in mice[J].Peptides,2014,56(3):163-172.
[15]XING Yanli,HE Jie,HOU Jian,et al.Gender differences in CMS and the effects of antidepressant venlafaxine in rats[J].Neurochemistry International,2013,63(6):570-575.
[16]THASE M E,ENTSUAH R,CANTILLON M,et al.Relative antidepressant efficacy of venlafaxine and SSRIs:sex-age interactions[J].Journal of Women’s Health,2005,14(7):609-616.