The Study Of Duloxetine And Sertraline In Treatment Of Geriatric Depression And The Impact Of Life Event On The Curative Effect

ObjectiveTo comparatively analyze the clinical effects and adverse reactions of duloxetine and sertraline in treatment of geriatric depression(GD)and the correlation between the negative life events before disease and the curative effect.MethodsThe objects are 97 patients that fit the ICD-10 depression diagnosis and aged over 60 years old.They were randomly divided into duloxetine group(49 cases)and sertraline group(48 cases),and given duloxetine(60 mg/d)and sertraline(50-100 mg/d)treatments for six weeks.Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were used before treatment and 1,2,4,and 6 weeks after treatment to assess the patients.The adverse reactions in the treatment were assessed with Treatment Emergent Symptom Scale(TESS)for the patients.The assessments of the negative life events of the patients before depression were made with Life Event Scale(LES).ResultsThe assessments of the duloxetine and sertraline groups with HAMD and HAMA scores were made before treatment,by comparison there were no significant difference(P>0.05).The HAMD and HAMA scores of the two groups after treatment of 1,2,4 and 6 weeks were lower than that before treatment,and the scores of the duloxetine group were all lower than that of the sertraline group,and by comparison there were significant difference(P<0.05).In duloxetine group,19 cases were cured,14 had marked effect,10 were effective,and 6 without effect,the total efficiency was 87.76%;in sertraline group,10 cases were cured,15 had marked effect,12 were effective,and 11 without effect,the total efficiency was 77.08%,the total effective rate in duloxetine group was higher than that in sertraline group,and by comparison there were significant difference(P<0.05).Adverse reactions occurred in the early treatments of the two groups,but the symptoms were mild,without special treatments,they all eased with the treatment process.In duloxetine group,the incidence of adverse reactions was 16.33%(3 cases of mild stomach upset,3 cases of nausea and 2 cases of vomiting);in sertraline group,the incidence of adverse reactions was 14.58%(3 cases of mild stomach upset,1 case of nausea,3 cases of dizziness),the incidence of adverse reactions in duloxetine group is higher than that in sertraline group,but by comparison the difference of two groups has no statistical significance(P>0.05).The two groups of patients were analyzed by LES before treatment,by statistics and comparison we see that the difference of the negative life event scores of the two groups have no statistical significance(P>0.05).From the analysis on the score of negative life events after treatment and the decreasing rate of HAMD score before and after treatment,we see the negative life events of the patients before disease have negative correlation with the curative effect.The higher the score of negative life events,the lower the decreasing rate of HAMD score.ConclusionThe negative life events of GD patients before disease have substantial negative correlation with the curative effect,the larger the impact of the negative life events on the GD patients before disease,the worse the curative effect afterwards.Duloxetine shows better clinical effect than sertraline for the treatment of geriatric depression with light adverse reactions,it is a safe and effective treatment method.