Kalay Aysegul E, Demir Berfu, Haberal Ali, Kalay Mustafa, Kandemir Omer
Department of Obstetrics and Gynecology, Alanya Sifa, Medical Center, Antalya, Turkey.
Menopause. 2007 Mar-Apr;14(2):223-9. doi: 10.1097/01.gme.0000243571.55699.4a.
The aim of this study was to evaluate the efficacy of citalopram for climacteric symptoms and to assess the combined effect of citalopram and hormone therapy (HT) on climacteric symptoms in women inadequately responsive to HT alone.
The study included 100 postmenopausal women who were allocated into one of four groups: (1) citalopram, (2) placebo, (3) citalopram+HT, or (4) placebo+HT. The women who were unable or unwilling to take HT were randomly placed in groups 1 and 2. The women who were inadequately responsive to HT were randomly placed in groups 3 and 4. The initial dose of citalopram was 10 mg/day in groups 1 and 3. After 1 week, the dose was increased to 20 mg/day. After starting the medication, follow-up visits took place during the fourth and eighth weeks of treatment. During the first and eighth weeks, women completed two questionnaires: a modified Kupperman index and the Menopause-Specific Quality of Life Questionnaire.
Mean hot flash scores significantly improved in all groups (P<0.05). The reduction rates were 37% in group 1, 13% in group 2, 50% in group 3, and 14% in group 4. Psychosocial complaints and mean values on the Kupperman index significantly decreased in all groups (P<0.05). Physical well-being significantly improved in groups 1, 3, and 4 (P<0.05). The decrease in all scores was significantly greater in groups 1 and 3 compared to groups 2 and 4 (P<0.01).
Citalopram is an effective alternative treatment option for patients who do not want to take HT for the alleviation of climacteric symptoms. Adjuvant treatment with a selective serotonin reuptake inhibitor increases the effectiveness of HT for the treatment of climacteric symptoms in women who had responded inadequately to HT.
本研究旨在评估西酞普兰对更年期症状的疗效,并评估西酞普兰与激素疗法(HT)联合应用对单独使用HT反应不佳的女性更年期症状的综合影响。
该研究纳入了100名绝经后女性,她们被分为四组之一:(1)西酞普兰组,(2)安慰剂组,(3)西酞普兰+HT组,或(4)安慰剂+HT组。无法或不愿接受HT的女性被随机分为第1组和第2组。对HT反应不佳的女性被随机分为第3组和第4组。第1组和第3组中西酞普兰的初始剂量为10毫克/天。1周后,剂量增加至20毫克/天。开始用药后,在治疗的第四周和第八周进行随访。在第一周和第八周,女性完成两份问卷:改良的库珀曼指数和更年期特异性生活质量问卷。
所有组的平均潮热评分均显著改善(P<0.05)。第1组的降低率为37%,第2组为13%,第3组为50%,第4组为14%。所有组的社会心理抱怨和库珀曼指数的平均值均显著降低(P<0.05)。第1组、第3组和第4组的身体健康状况显著改善(P<0.05)。与第2组和第4组相比,第1组和第3组所有评分的降低幅度显著更大(P<0.01)。
对于不想通过服用HT来缓解更年期症状的患者,西酞普兰是一种有效的替代治疗选择。用选择性5-羟色胺再摄取抑制剂进行辅助治疗可提高HT对单独使用HT反应不佳的女性更年期症状的治疗效果。