Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life
Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life
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DOI：
10.1176/appi.ajp.157.5.729
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发表时间：
2000-05-01
影响因子：
17.7
通讯作者：
Batzar, E
中科院分区：
文献类型：
--
作者：
Bondareff, W;Alpert, M;Batzar, E
目的：本研究旨在评估舍曲林和去甲替林治疗老年人重度抑郁症的比较疗效和安全性。方法：采用双盲平行组设计，对 210 名 60 岁及以上门诊患者进行比较，这些患者符合 DSM-III-R 重度抑郁发作标准，且汉密尔顿抑郁评定量表得分最低为 18。患者被随机分配接受舍曲林治疗 12 周。 （50-150 毫克/天）或去甲替林（25-100 毫克/天）。结果：两种治疗的安全性相似，只是去甲替林治疗与脉搏率显着增加相关，而舍曲林与脉搏率不显着降低相关。两种药物在所有时间点的疗效相似，71.6%（74 名中的 53 名）接受舍曲林治疗的患者和 70 名中去甲替林治疗的 61.4%（70 名中的 43 名）患者在第 12 周时达到缓解状态。缓解时间也相似，汉密尔顿抑郁量表评分的改善超过 75% 发生在第 6 周。次要疗效指标（治疗后指标认知功能、记忆力和生活质量）显示舍曲林治疗具有显着优势。结论：主要疗效指标显示舍曲林和去甲替林具有相似的效果。通过次要结果测量，一致的证据表明舍曲林治疗组具有优势。应在维持治疗研究中检查这些措施对老年抑郁症患者长期健康的临床影响。
Objective: This study was designed to evaluate the comparative efficacy and safety of sertraline and nortriptyline for the treatment of major depressive disorder in older adults.Method: A double-blind, parallel group design was used to compare 210 outpatients, 60 years of age and older, who met DSM-III-R criteria for major depressive episode and had a minimum Hamilton Depression Rating Scale score of 18. The patients were randomly assigned to 12 weeks of treatment with either sertraline (50-150 mg/day) or nortriptyline (25-100 mg/day).Results: The safety profiles of the two treatments were similar except that nortriptyline treatment was associated with a significant increase in pulse rate, whereas sertraline was associated with a nonsignificant decrease. Efficacy of both drugs was similar for both treatments at all time points, with 71.6% (N=53 of 74) of the sertraline-treated patients and 61.4% (N=43 of 70) of the nortriptyline-treated patients achieving responder status by week 12. Time to response was also similar, with more than 75% of the improvement in scores on the Hamilton depression scale having occurred by week 6. Secondary efficacy measures (posttreatment measures of cognitive function, memory and quality of life) revealed a significant advantage for sertraline treatment.Conclusions: Primary efficacy measures showed sertraline and nortriptyline to be similarly effective. With secondary outcome measures there was consistent evidence of an advantage for the sertraline-treated group. The clinical impact of these measures on the longterm well-being of elderly depressed patients should be examined in a study of maintenance treatment.