Kasper Siegfried, Lemming Ole Michael, de Swart Hans
Medical University of Vienna, Vienna, Austria.
Neuropsychobiology. 2006;54(3):152-9. doi: 10.1159/000098650. Epub 2007 Jan 17.
The primary aim was to investigate the long-term safety and tolerability of escitalopram (10 or 20 mg/day) treatment of elderly patients suffering from major depressive disorder. The secondary aim was to examine response to treatment, as measured by change in the Montgomery-Asberg Depression Rating Scale (MADRS) total score from study entry to each visit, using observed cases.
This extension trial included 225 patients who had completed an 8-week, double blind, placebo-controlled lead-in study, which was performed in outpatients in primary care and in specialist clinics. The intent-to-treat population comprised 223 patients.
The overall withdrawal rate was 24%. The most common reason for withdrawal was adverse events (9%). The 5 most common adverse events were accidental injury, rhinitis, weight increase, arthralgia and coughing, with an incidence ranging from 8 to 13%. No new types of adverse events were reported in this extension study compared to the 8-week lead-in study. The mean weight increased from 69.7 kg at study entry to 70.3 kg at endpoint. The percentage of patients in remission (MADRS total score < or = 12) increased from 48% at study entry to 72% by week 52.
Escitalopram demonstrated a favourable tolerability profile during 52 weeks of open-label treatment of elderly patients, with further improvement in depressive symptoms.
主要目的是调查艾司西酞普兰(10或20毫克/天)治疗老年重度抑郁症患者的长期安全性和耐受性。次要目的是使用观察病例,通过从研究入组到每次访视时蒙哥马利-阿斯伯格抑郁评定量表(MADRS)总分的变化来检查治疗反应。
这项延长期试验纳入了225名完成了为期8周的双盲、安慰剂对照导入期研究的患者,该导入期研究在初级保健门诊患者和专科诊所进行。意向性治疗人群包括223名患者。
总体退出率为24%。最常见的退出原因是不良事件(9%)。5种最常见的不良事件是意外伤害、鼻炎、体重增加、关节痛和咳嗽,发生率在8%至13%之间。与8周的导入期研究相比,该延长期研究未报告新的不良事件类型。平均体重从研究入组时的69.7千克增加到终点时的70.3千克。缓解患者(MADRS总分≤12)的比例从研究入组时的48%增加到第52周时的72%。
在对老年患者进行52周的开放标签治疗期间,艾司西酞普兰显示出良好的耐受性,抑郁症状进一步改善。