Feiger Alan D, Flament Martine F, Boyer Patrice, Gillespie John A
Feiger Health Research Center, Wheat Ridge, Colorado 80033, USA.
Int Clin Psychopharmacol. 2003 Jul;18(4):203-10. doi: 10.1097/00004850-200307000-00002.
The aim of this study was to examine response and remission rates in outpatients treated with sertraline or fluoxetine who were suffering from two depression subtypes: anxious-depression and severe depression. Data were pooled from five double-blind studies comparing fluoxetine versus sertraline for the treatment of DSM-III-R or IV major depression. Clinical outcome was assessed using the Hamilton Depression Rating Scale (HAM-D) and the Clinical Global Impression-Improvement scale (CGI-I). One thousand and eighty-eight patients were randomized, with 654 (60%) meeting criteria for anxious depression and 212 (19%) meeting criteria for high severity depression. For the total sample, treatment response was similar for both sertraline and fluoxetine. In the high severity subgroup, the mean (+/-SD) HAM-D score at week 12 was 8.9+/-5.7 for sertraline and 10.8+/-6.9 for fluoxetine (P=0.07), and the mean (+/-SD) CGI-I score was 1.5+/-0.7 for sertraline and 2.0+/-1.1 for fluoxetine (P=0.005). CGI-I responder rates were 88% versus 71% (P=0.03) in the high severity subgroup, and 84% versus 79% (P=0.16) in the anxious-depression subgroup. Overall, sertraline and fluoxetine showed comparable antidepressant efficacy, although sertraline may offer an advantage in those patients with severe depression.
本研究的目的是考察接受舍曲林或氟西汀治疗的门诊患者的反应率和缓解率，这些患者患有两种抑郁症亚型：焦虑性抑郁症和重度抑郁症。数据来自五项比较氟西汀与舍曲林治疗DSM-III-R或IV重度抑郁症的双盲研究。使用汉密尔顿抑郁量表（HAM-D）和临床总体印象改善量表（CGI-I）评估临床结局。1088名患者被随机分组，其中654名（60%）符合焦虑性抑郁症标准，212名（19%）符合高严重性抑郁症标准。对于总样本，舍曲林和氟西汀的治疗反应相似。在高严重性亚组中，舍曲林在第12周时的平均（±标准差）HAM-D评分为8.9±5.7，氟西汀为10.8±6.9（P = 0.07），舍曲林的平均（±标准差）CGI-I评分为1.5±0.7，氟西汀为2.0±1.1（P = 0.005）。在高严重性亚组中，CGI-I反应率分别为88%和71%（P = 0.03），在焦虑性抑郁症亚组中分别为84%和79%（P = 0.16）。总体而言，舍曲林和氟西汀显示出相当的抗抑郁疗效，尽管舍曲林可能对重度抑郁症患者具有优势。
