西酞普兰与度洛西汀治疗抑郁症的性别与年龄差异

西酞普兰与度洛西汀治疗抑郁症的性别与年龄差异

作者：黄飞姜祥智

来源：《青岛大学学报（医学版）》2019年第01期

[摘要];目的探讨西酞普兰与度洛西汀治疗抑郁症的性别与年龄差异。

方法将207例抑郁症病人随机分为西酞普兰组（110例）和度洛西汀组（97例），分别给予西酞普兰和度洛西汀口服治疗6周，分别于治疗前及治疗1、2、4、6周末，采用汉密尔顿抑郁量表（HAMD）评定疗效。

结果治疗后两组HAMD评分均较治疗前明显降低，差异有统计学意义（F=35.49、48.92，P<0.01）;治疗前后两组间HAMD评分比较差异均无显著性（P>0.05）。两组男性病人治疗后HAMD评分变化差异均无统计学意义（P>0.05），西酞普兰组女性病人治疗4、6周末的HAMD评分变化大于度洛西汀组女性病人，差异有统计学意义（F=2.50、2.53，P<0.05）。西酞普兰组女性病人治疗后HAMD评分变化与年龄呈负相关（r=-0.25，P<0.05）。

结论西酞普兰和度洛西汀总体抗抑郁治疗效果相当，西酞普兰治疗女性抑郁症病人效果優于度洛西汀，且对年轻女性病人疗效优于老年女性，而度洛西汀治疗抑郁症效果没有性别和年龄差异。

[关键词];抑郁症;西酞普兰;度洛西汀;治疗结果;性别特性;年龄因素

[中图分类号];R749.41

[文献标志码];A

[文章编号];;2096-5532（2019）01-0095-04

IMAPCTS OF GENDER AND AGE ON THE EFFICACY OF CITALOPRAM AND DULOXETINE FOR DEPRESSION

HUANG Fei， JIANG Xiangzhi

（Department of Psychiatry， Qingdao Mental Health Center， Qingdao 266034， China）

[ABSTRACT]ObjectiveTo investigate the impacts of gender and age on the efficacy of citalopram and duloxetine for depression.

MethodsA total of 207 patients with depression were randomly divided into citalopram group （n=110） and duloxetine group （n=97）. The two groups received oral administration of citalopram and duloxetine， respectively， for 6 weeks. The treatment outcomes were evaluated by the Hamilton Depression （HAMD） Scale before treatment and after 1，2，4， and 6 weeks of treatment.

ResultsAfter treatment， the HAMD score was significantly reduced in both groups

（F=35.49，48.92;P<0.05）. There was no significant difference in the HAMD score before or after treatment between the two groups （P>0.05）. For male patients， there was no significant difference in the change in the HAMD score after treatment between the two groups （P>0.05）. For female patients， the changes in the HAMD score after 4 and 6 weeks of treatment were significantly greater in the citalopram group than in the duloxetine group （F=2.50，2.53;P<0.05）. The change in the HAMD score after treatment was negatively correlated with age among the female patients in the citalopram group （r=-0.25，P<0.05）.

ConclusionThe overall efficacy of citalopram and duloxetine is similar in the treatment of depression. Citalopram has superior antidepressant efficacy to duloxetine among female patients. Citalopram also achieves better antidepressant outcomes in young females than in elderly females. By contrast， gender and age have no impacts on the antidepressant efficacy of duloxetine.

[KEY WORDS]depressive disorder; citalopram; duloxetine; treatment outcome; gender identity; age factors

抑郁症的发病存在性别差异，女性的发病率高于男性。但为了避免月经周期对药物代谢的影响，抗抑郁药物的前期研究一般仅选用雄性动物和年轻健康的男性作为研究对象，这就造成药物上市后其临床疗效和副作用往往存在性别差异，所以近年来国外逐渐开始将更多的精力投入到性别差异对药物代谢的影响研究上。有研究显示，三环类抗抑郁药对男性的疗效要优于女性[1]，而5-羟色胺再摄取抑制剂（SSRIs）对女性的疗效要明显优于男性[2]。另有临床研究显示，与男性抑郁症病人相比，女性病人经抗抑郁药治疗后更易复发，且高泌乳素血症发生率也