Systematic Review of Escitalopram versus Paroxetine in Treatment of Senile Patients with Depression in China / 中国药房

ABSTRACT

OBJECTIVE:To systematically review the efficacy and safety of escitalopram versus paroxetine in treatment of se-nile patients with depression in China,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP,Wanfang database,CBM database,randomized controlled trials(RCT)of escitalopram(test group)versus paroxetine (control group) in the treatment of senile patients with depression in China were collected. After quality evaluation and data ex-tract,Meta-analysis was performed by using Rev Man 4.2 statistics software. RESULTS:A total of 14 RCT were included,involv-ing 1 148 patients. Results of Meta-analysis showed there was no significant difference in the cure rate[OR=1.20,95%CI(0.93, 1.53),P=0.16],significant effective rate[OR=1.23,95%CI(0.94,1.61),P=0.12],the incidences of headache[OR=0.81,95%CI (0.40,1.65),P>0.05],the incidences of tachycardia [OR=0.37,95%CI(0.09,1.52),P>0.05],the incidences of insomnia [OR=1.26,95%CI(0.33,4.82),P>0.05] and the incidences of tremor [OR=0.31,95%CI(0.04,2.24),P>0.05] between test group and control group;the incidences of xerostomia[OR=0.50,95%CI(0.31,0.80),P<0.05],the incidences of nausea[OR=0.49,95%CI (0.36,0.66),P<0.05],the incidences of sweating [OR=0.31,95%CI(0.15,0.62),P<0.05],the incidences of constipation[OR=0.31,95%CI(0.15,0.64),P<0.05],the incidences of dizziness[OR=0.38,95%CI(0.20,0.72),P<0.05] and the incidences of an-orexia[OR=0.45,95%CI(0.21,0.99),P<0.05] in test group were significantly lower than control group,there were significant dif-ferences in 2 groups. CONCLUSIONS:The efficacy of escitalopram and paroxetine is similar in the treatment of senile patients with depression,however,the safety of escitalopram is better than paroxetine. Due to the limit of methodological quality and sam-ple size,it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.