Department of Psychiatry, Avicenna Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Psychiatry Clin Neurosci. 2010 Apr;64(2):128-33. doi: 10.1111/j.1440-1819.2009.02055.x. Epub 2010 Feb 1.
Generalized anxiety disorder (GAD) in elderly people is common, but few systematic studies regarding the best treatments have been performed. The aim of the present study was to evaluate the efficacy and safety of sertraline and buspirone in the treatment of elderly patients with GAD.
Based on selection criteria, 46 patients were recruited who met DSM-IV criteria for GAD. Patients were randomly assigned to sertraline (50-100 mg/day) or buspirone (10-15 mg/day) for 8 weeks in a single-blind trial. The primary outcome measure used in the present study was the Hamilton Rating Scale for Anxiety (HRSA).
Both sertraline and buspirone had significant anxiolytic efficacy. A steady decrease in the total HRSA scores for both groups was observed throughout the study period. After 2 and 4 weeks, buspirone was found to be significantly superior to sertraline (P < 0.001), but at the end of study period this difference did not reach statistical significance (P = 0.16). The mean HRSA score after 8 weeks significantly decreased in subjects treated with sertraline (P < 0.001), and buspirone (P < 0.001). No clinically adverse events or changes in laboratory test results were observed during the study period.
Both sertraline and buspirone appear to be efficacious and well tolerated in the treatment of GAD in elderly patients. Further studies with larger sample size, evaluating the effect of medical illness, cognitive impairment, depression, and combined therapy with support and psychotherapy are needed.
老年人广泛性焦虑障碍(GAD)较为常见,但针对最佳治疗方法的系统研究较少。本研究旨在评估舍曲林和丁螺环酮治疗老年 GAD 患者的疗效和安全性。
根据入选标准,共招募了 46 名符合 DSM-IV GAD 诊断标准的患者。患者被随机分配至舍曲林(50-100mg/天)或丁螺环酮(10-15mg/天)治疗组,进行为期 8 周的单盲试验。本研究的主要疗效指标为汉密尔顿焦虑量表(HRSA)评分。
舍曲林和丁螺环酮均具有显著的抗焦虑疗效。两组的 HRSA 总分在整个研究期间均呈持续下降趋势。治疗 2 周和 4 周后,丁螺环酮组的疗效明显优于舍曲林组(P<0.001),但在研究结束时,这种差异无统计学意义(P=0.16)。治疗 8 周后,舍曲林组(P<0.001)和丁螺环酮组(P<0.001)的 HRSA 评分均值均显著降低。在研究期间,两组均未观察到临床不良事件或实验室检查结果的变化。
舍曲林和丁螺环酮均对老年 GAD 患者有效且耐受良好。需要进一步开展样本量更大的研究,评估疾病状态、认知功能障碍、抑郁以及联合支持和心理治疗的影响。