Effects Of SSRI And SNRI On Preliminary Diagnostic Major Depressed Patients' Cognition Function, Thyroid Hormone And STSH

Object: This thesis aims to probe the effect of SSRIs and SNRIs on preliminary diagnostic major depressed patients' cognitive function, thyroid hormones and sTSH, and seek the possibly optimized therapies for the patients.Method: The subjects were patients who were diagnosed initially as major depression on the standards referred to the ICD-10. All measures were taken in the First Affiliated Hospital of Nanchang University from July 2009 to December 2009. The patients with score HAMD17≥17 were recruited,and those who has taken antipsychotics within the two weeks prior to treatment in hospital were excluded. After obtaining the Written informed consent,the 72 patients between the age of 18 and 60 were randomized to Venlafaxine Hydrocloride group, Paroxetine Hydrochloride group and control group by the researchers for 12 weeks. During the study the use of all the psychotropic drugs were prohibited except benzodiazepine. Venlafaxine were administrated with dose of 75-225mg/d and Paroxetine with dose of 20-40mg/d. In the 4th, 8th and 12th week of the treatment the HAMD17 scale was evaluated. Neuropsychological assessments (WMS-RC) and identification of the serum level of thyroid hormones and sTSH were conducted before and after the treatment. All the data were analyzed statistically with software SPSS17.0.Result: It has no significance between the two groups in scores of HAMD17 before the therapies. However, the results indicated significant differences in both groups in the 4th and 8th weeks of posttreatmet. In the 4th and 8th weeks compared with paroxetine group, venlafaxine group score was much more on HAMD17 reduction, the difference was significant. There was no difference of HAMD17 reduction scores between the Venlafaxine Hydrocloride group and Paroxetine Hydrochloride group after 12 weeks therapies. The score of cognitive function in study group were lower than control group. After the complete treatment, the memory obviously improved in both groups. The score of cognitive function was no differences between the Venlafaxine Hydrocloride group and the Paroxetine Hydrochloride group. Thyroid hormone therapy group and sTSH three levels of analysis of variance showed no statistically significant with all values in the normal range. After treatment, the levels of thyroid hormone and sTSH in the Venlafaxine group and the Paroxetine group were within normal limits. it is found that the serum level of FT4 of the patients were significantly lower, the serum level of sTSH were significantly higher, while no significant difference was found in serum level of FT3 after the therapies.Conclusion: Patients with newly diagnosed depression often were accompanied by cognitive impairment involving the damage of memory. Both Venlafaxine and Paroxetine in patients with depression can improve cognitive function. There was no differences in improving cognitive function in both cases of Venlafaxine and Paroxetine Hydrocloride groups. The serum level of FT3, FT4 and sTSH of the patients before and after treatment were in normal range. The serum level of FT4 was significantly lower and that of sTSH was higher after the therapies.