Chokka Pratap, Legault Mark
Grey Nuns Community Hospital, Edmonton, Canada.
Depress Anxiety. 2008;25(12):E173-81. doi: 10.1002/da.20458.
The present trial was designed to assess the efficacy and safety of escitalopram prescribed to patients seeking treatment of major depressive disorder (MDD) in a Canadian primary-care setting.
Investigators (mainly primary-care physicians) enrolled patients with MDD from their daily practice. Patients were treated with escitalopram (flexible dose 10-20 mg/day) for up to 24 weeks. Efficacy assessments included the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impression-Improvement and -Severity scales (CGI-I, CGI-S), the Patient Global Evaluation (PGE), and the Medical Outcome Study 36-item Short Form (SF-36).
Out of the 647 patients enrolled, 461 (71%) completed 24 weeks of treatment. The most common reason for discontinuation was adverse events (10%). The mean MADRS score decreased from 30.7 at baseline to 10.9 at the end of 24 weeks (last observation carried forward, LOCF). Remission (MADRS<or=12) was achieved by 65.5% of patients (LOCF). Symptom improvements were confirmed by global ratings of improvement made by physicians (CGI-I) as well as patients PGE. There was improvement on all dimensions of the SF-36, suggesting an overall improvement in quality of life.
Escitalopram was well tolerated, safe, and efficacious. Escitalopram can be used with confidence to treat patients with MDD in Canadian primary-care settings.
本试验旨在评估在加拿大初级保健环境中，给患有重度抑郁症（MDD）的患者开具艾司西酞普兰的疗效和安全性。
研究人员（主要是初级保健医生）从日常诊疗中招募MDD患者。患者接受艾司西酞普兰治疗（灵活剂量为10 - 20毫克/天），最长治疗24周。疗效评估包括蒙哥马利-艾斯伯格抑郁评定量表（MADRS）、临床总体印象-改善和-严重程度量表（CGI-I、CGI-S）、患者总体评估（PGE）以及医学结局研究简明健康调查36项量表（SF-36）。
在647名入组患者中，461名（71%）完成了24周的治疗。最常见的停药原因是不良事件（10%）。MADRS平均得分从基线时的30.7降至24周结束时的10.9（末次观察向前结转，LOCF）。65.5%的患者（LOCF）实现了缓解（MADRS≤12）。医生对改善情况的总体评定（CGI-I）以及患者的PGE均证实了症状的改善。SF-36的所有维度均有改善，表明生活质量总体有所提高。
艾司西酞普兰耐受性良好、安全且有效。在加拿大初级保健环境中，可放心使用艾司西酞普兰治疗MDD患者。
