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艾司西酞普兰在中国抑郁症和焦虑症患者中进行的为期8周开放性研究的安全性和有效性。

Safety and effectiveness of escitalopram in an 8-week open study in Chinese patients with depression and anxiety.

作者信息

Wang Gang, You Xiumin, Wang Xueyi, Xu Xiufeng, Bai Ludong, Xie Jian, Yao Zhijian, Yi QiZhong, Ma Jun, Wang Jinan, Zhuo Jianmin, Hu Cuili

机构信息

Psychiatry Department, Beijing Anding Hospital, Capital Medical University, National Clinical Research Center for Mental Disorders, Beijing, China.

Psychiatry Department, Xianyue Hospital, Xiamen, China.

出版信息

Neuropsychiatr Dis Treat. 2018 Aug 14;14:2087-2097. doi: 10.2147/NDT.S164673. eCollection 2018.

Abstract

BACKGROUND

Anxiety symptoms usually worsen depression and functional impairment. The present study was aimed to evaluate the impact of escitalopram on social function and quality of life in major depressive disorder (MDD) patients with anxiety symptoms.

PATIENTS AND METHODS

Adult MDD patients with functional impairment (Sheehan Disability Scale [SDS] score ≥9) and anxiety symptoms (Hamilton Anxiety Rating Scale [HAM-A] score ≥14) received escitalopram (10-20 mg/day) for 8 weeks. Symptom status was assessed by SDS, Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form, Montgomery-Åsberg Depression Rating Scale (MADRS), HAM-A, and Quick Inventory of Depressive Symptomatology-Self Report scales. Safety was evaluated by treatment-emergent adverse events (TEAEs).

RESULTS

Overall, 208 (79.7%) of 261 enrolled patients completed the 8-week treatment. Mean (SD) SDS and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form total scores were 17.4 (5.87) and 39.3 (14.43) at baseline, which improved to 7.6 (6.71) and 61.6 (15.80), respectively, at week 8. Totally, 59.2% of patients achieved functional remission (SDS≤6) and 61.7% of patients achieved depression remission (MADRS≤10) at week 8; 48.1% of patients achieved both functional and depression remission (SDS≤6 and MADRS≤10). The change in SDS total score was positively correlated with the change in MADRS and HAM-A total scores at each visit. Patient's baseline SDS score was related with depression score (regression coefficient=0.40582, =0.0005); remission of SDS was statistically related to a reduction of week 2 and week 6 HAM-A score (<0.0001) and reduction of MADRS score (<0.0001). Overall, 25.7% of patients reported ≥1 TEAEs. Most frequently reported TEAEs were nausea (5.8%), diarrhea (2.3%), and dizziness (2.7%). Most TEAEs were mild to moderate in severity. Four patients reported serious TEAEs, two patients reported suicide attempts, and one patient completed suicide.

CONCLUSION

Escitalopram (10-20 mg/day) treatment was efficacious in reducing depression, improving social function, and quality of life in MDD patients with anxiety symptoms. No new safety signals were identified.

摘要

背景

焦虑症状通常会加重抑郁及功能损害。本研究旨在评估艾司西酞普兰对伴有焦虑症状的重度抑郁症(MDD)患者社会功能及生活质量的影响。

患者与方法

有功能损害(希恩残疾量表[SDS]评分≥9)且有焦虑症状(汉密尔顿焦虑量表[HAM - A]评分≥14)的成年MDD患者接受艾司西酞普兰(10 - 20毫克/天)治疗8周。通过SDS、生活质量享受与满意度问卷简表、蒙哥马利 - 阿斯伯格抑郁评定量表(MADRS)、HAM - A以及抑郁症状快速自评量表评估症状状态。通过治疗中出现的不良事件(TEAE)评估安全性。

结果

总体而言,261名入组患者中有208名(79.7%)完成了8周治疗。基线时SDS及生活质量享受与满意度问卷简表总分的均值(标准差)分别为17.4(5.87)和39.3(14.43),在第8周时分别改善至7.6(6.71)和61.6(15.80)。在第8周时,共有59.2%的患者实现功能缓解(SDS≤6),61.7%的患者实现抑郁缓解(MADRS≤10);48.1%的患者实现功能和抑郁双缓解(SDS≤6且MADRS≤10)。每次访视时SDS总分的变化与MADRS及HAM - A总分的变化呈正相关。患者的基线SDS评分与抑郁评分相关(回归系数 = 0.40582,P = 0.0005);SDS的缓解与第2周和第6周HAM - A评分的降低(P<0.0001)以及MADRS评分的降低(P<0.0001)具有统计学相关性。总体而言,25.7%的患者报告了≥1次TEAE。最常报告的TEAE为恶心(5.8%)、腹泻(2.3%)和头晕(2.7%)。大多数TEAE的严重程度为轻度至中度。4名患者报告了严重TEAE,2名患者报告有自杀未遂,1名患者自杀身亡。

结论

艾司西酞普兰(10 - 20毫克/天)治疗对于减轻伴有焦虑症状的MDD患者的抑郁、改善其社会功能及生活质量有效。未发现新的安全信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bff/6097511/27873c37dbb1/ndt-14-2087Fig1.jpg

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