Escitalopram versus ethinyl estradiol and norethindrone acetate for symptomatic peri- and postmenopausal women: impact on depression, vasomotor symptoms, sleep, and quality of life
Escitalopram versus ethinyl estradiol and norethindrone acetate for symptomatic peri- and postmenopausal women: impact on depression, vasomotor symptoms, sleep, and quality of life
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DOI：
10.1097/01.gme.0000240633.46300.fa
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发表时间：
2006-09
期刊：
影响因子：
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通讯作者：
C. Soares;Helga Arsenio;H. Joffe;B. Bankier;P. Cassano;Laura Petrillo;L. Cohen
中科院分区：
文献类型：
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作者：
C. Soares;Helga Arsenio;H. Joffe;B. Bankier;P. Cassano;Laura Petrillo;L. Cohen
目的：比较艾司西酞普兰（ESCIT）与雌激素和孕激素治疗（EPT）治疗有症状的围绝经期和绝经后妇女的疗效和耐受性。设计：40名患有抑郁症和更年期相关症状的女性（40-60岁）被随机分配到ESCIT（灵活剂量，10- 20mg /天；固定剂量，前4周10mg /天）或雌激素加孕激素治疗（雌二醇5 g/天加醋酸去甲稀酮1 mg/天）的8周开放试验中。第8周的主要结局指标包括Montgomery-Asberg抑郁评定量表和Greene更年期量表。次要结果测量包括临床总体印象以及睡眠和生活质量评估。结果：32例女性（16例EPT， 16例ESCIT）纳入分析。56%（9/16）接受ESCIT治疗的女性抑郁完全缓解（格林更年期量表评分降低50%），而接受EPT治疗的女性抑郁完全缓解率为31.2% (5/16)（P = 0.03, Pearson's 2检验）。两种治疗方法在睡眠、潮热和生活质量方面均有改善。结论：ESCIT治疗抑郁症比EPT更有效，对其他绝经相关症状也有积极影响。对于不能或不愿使用激素治疗的有症状的绝经妇女，ESCIT可能是一种治疗选择。
Objective: To examine the efficacy and tolerability of escitalopram (ESCIT) compared to estrogen and progestogen therapy (EPT) for the treatment of symptomatic peri- and postmenopausal women. Design: Forty women (aged 40-60 years) with depressive disorders and menopause-related symptoms were randomly assigned to an 8-week open trial with ESCIT (flexible dose, 10-20 mg/day; fixed dose, 10 mg/day for the first 4 weeks) or estrogen plus progestogen therapy (ethinyl estradiol 5 g/day plus norethindrone acetate 1 mg/day). Primary outcome measures included Montgomery-Asberg Depression Rating Scale and the Greene Climacteric Scale at week 8. Secondary outcome measures included the Clinical Global Impressions as well as sleep and quality of life assessments. Results: Thirty-two women (16 on EPT, 16 on ESCIT) were included in the analyses. Full remission of depression (score of 50% decrease in Greene Climacteric Scale scores) was noted in 56% (9/16) of women treated with ESCIT compared to 31.2% (5/16) on EPT (P = 0.03, Pearson's 2 tests). Improvement in sleep, hot flashes, and quality of life was observed with both treatments. Conclusions: ESCIT is more efficacious than EPT for the treatment of depression and has a positive impact on other menopause-related symptoms. ESCIT may constitute a treatment option for symptomatic menopausal women who are unable or unwilling to use hormone therapy.