Comparison of clinical efficacy between escitalopram and fluoxetine in treatment of elderly depression

AM To study the efficacy and safety of escitalopram in the treatment of elderly depression.METHODS This was a randomized,open-label,6-week flexible dose study.Sixty patients were diagnosed as elderly depression based on Chinese classification and diagnostic criteria for mental disorders.The patients were randomly assigned to escitalopram treatment group with escitalopram 10 - 20 mg·d~(-1)(n=30) and fluoxetine treatment group with fluoxetine 20-40mg·d~(-1)(n = 30).Clinical effectiveness was evaluated with Hamilton depression scale(HAMD),and adverse drug reactions and safety were assessed with treatment emergent symptom scale(TESS )and by laboratory examination. RESULTS The response rate and remission rate were 70.4%and 44.5%for escitalopram treatment group and were 69.28%and 42.3%for fluoxetine treatment group,respectively.There was no statistically significant difference between 2 groups for both rates.But the HAMD score of escitalopram treatment group at the end of one week significantly decreased compared with that before treatment,and statistical difference existed between 2 groups(P 0.05).The main adverse drug reactions of escitalopram treatment group were lack of appetite,nausea,dizziness(each 3 patients,10%), and sleepless,dry mouth,palpitation(each 2 patients,6.7%),and constipation,lethargy(each 1 patients,3.3%),with no statistically significant difference compared with fluoxetine treatment group.CONCLUSION Escitalopram is more effective, while the efficacy and the adverse drug reactions are similar to fluoxetine.