The Effects Of Escitalopram And Venlafaxine On The Social Function And Quality Of Life In Depression

ObjectiveTo compare the effectiveness and the impact of patient’s social function and quality of life between escitalopram and venlafaxine in patients with depressive disorder.Methods1.150first-episode patients that were consistent with the diagnostic criteria of depression in the International Statistical Classification of Diseases and Related Health Problems10th Revision (ICD-10) were divided randomly into two groups and treated with Escitalopram (10-20mg/d, n=79) and Venlafaxine (75-225mg/d, n=71). The drug’s treatment doses were adjusted according to the patients’ condition and the toleration. The observed treatment duration was8weeks.2. The therapeutic efficacy was assessed by the Hamilton Depression Scale (HAMD-17), the social function and the quality of life were measured with Sheehan Disability Scale (SDS) and the Short Form-36Health Survey (SF-36) before treatment and at the2nd,4th,8th weekend of the treatment. The side effects were evaluated by the Treatment Emergent Symptom Scale (TESS).3. The assessment results were input into SPSS16.0software for statistical analysis after being arranged. The numerical variable datas were analyzed by T Test or analysis of variance and the categorical datas were analyzed by Chi-Square Test or Fisher’s Exact Test. The ordinal datas were analyzed by Non-Parametric Test-Ridit analysis and then the affected factors were analyzed with Pearson Correlation analysis and Multiple Stepwise Regression analysis.Results1. The scores of HAMD of both groups decreased gradually after treatment and showed significant differences when compared with the baseline (P<0.01).There were no significant differences in the HAMD scores between the two groups at each interview point(P>0.05). After8weeks treatment, the efficient rate and remission rate of escitalopram group was95.8%and35.2%, venlafaxine group was90.3%and40.3%, there were no significant statistical differences in the efficient rate and remission rate between the two groups (P>0.05).2. There were no significant differences in SDS total scores and each factor score between the two groups before treatment (P>0.05). The total scores and each factor score of SDS in both groups decreased gradually with the prolong of the treatment and showed significant differences when compared with the baseline (P＜0.01). There were no significant differences in SDS total scores between the two groups after treatment(P>0.05) except the4th weekend(P<0.05). There were no significant differences in SDS2(social life) score and SDS3(family life) score between the two groups at different stages after treatment(P>0.05) in addition to SDS1(work/school) score(P<0.05or P＜0.01).3. There were no significant differences in the social functions factor scores of SF-36between the two groups before treatment (P>0.05). The social functions factor scores of SF-36of both groups increased at the8th weekend of the treatment and showed significant differences compared with the baseline (P＜0.01). At the8th weekend of the treatment, the Role-Emotional score in Venlafaxine group was higher than that of Escitalopram group, the difference was significant(P＜0.05), but the remaining factor score showed no statistical differences(P>0.05).4. Pearson correlation analysis showed that there were different degrees of correlation between SDS8weekend total scores, factor scores and this course of the disease, initial age of onset, HAMD scores before treatment, HAMD8weekend minus points, suicide risk. Multiple stepwise regression analysis showed that the scores of HAMD before treatment,the initial age of onset, this course of the disease and suicide risk are protective factors of SDS8weekend total scores and factor scores, while HAMD8weekend minus points are risk factors.5. There were no significant statistical differences in the frequency of adverse events between the two groups after treatment (P>0.05).Conclusion1. Both escitalopram and venlafaxine can better improve depressive symptoms in patients with depression, the efficacy of both were appropriate and showed no significant differences. Moreover, both had small adverse reactions and high security, can be used as the first selection of antidepressant treatment.2. Both escitalopram and venlafaxine can better improve the social function and enhance the quality of life in patients with depression, but venlafaxine inprove faster, can improve the social function in patients with depression earlier and venlafaxine inprove superior in work/school and role-emotional than that of escitalopram.3. The main factors which affected the recovery of social function in first-episode patients with depression were the severity of depression, drug efficiency,the initial age of onset, this course of the disease and suicide risk.