A Controlled Study On The Efficacy And Safety Of Vortioxetine And Escitalopram In The Treatment Of Depressive Disorder

Objective:To explore the efficacy of two antidepressants,Vortioxetine and Escitalopram,in improving clinical symptoms,social function and cognitive function in patients with depression,and to explore the safety of the two drugs by studying adverse reactions in order to guide clinical utilization.Methods:According to the diagnostic criteria of ICD-10,105 patients with depressive episode or recurrent depressive disorder were randomly divided into study group and control group.The study group was treated with Vortioxetine and the control group was treated with Escitalopram for 24 weeks.The efficacy and adverse reactions were evaluated with Hamilton Depression scale-17(HAMD-17),Sheehan Disability Scale(SDS),Patient Health questionnaire(PHQ-9),Cognitive Impairment Questionnaire-Depression(PDQ-D),Generalized Anxiety Scale-7(GAD-7)and Treatment Emergent Symptom Scale(TESS)before treatment and at the end of 8th and 24th week after treatment.SPSS 21.0 was used to analyze the data.The measurement data in accordance with normal distribution and homogeneity of variance were expressed as(x±s)and analyzed by t-test.Meanwhile,the counting data were expressed by counts and percentages[n,(%)],using ?2 test or Fisher's Exact Test.And P<0.05 means the difference is statistically significant.Results:1.During the baseline period,there was no significant difference in HAMD-17 total score,PHQ-9 and GAD-7 scores between the two groups.At the end of 8 and 24 weeks after drug intervention,the total scores of HAMD-17,PHQ-9 and GAD-7 in the two groups were significantly lower than those before treatment,but there was no significant difference in the total scores of HAMD-17,PHQ-9 and GAD-7 between the two group(?)the same time point(P>0.05).2.At the end of 8 weeks of treatment,there was no significant difference in the significant effective rate of depressive symptoms(HAMD-17 score reduction rate>50%)between the two groups.But at the end of 24 weeks of treatment,the significant effective rate of depressive symptoms in Escitalopram group was significantly higher than that in Vortioxetine group(P<0.05).3.During the baseline period,there was no significant difference in the scores of HAMD-17 cognitive impairment,PDQ-D and SDS between the two groups(P>0.05).At the end of 24 weeks after treatment,the scores of HAMD-17 cognitive impairment,PDQ-D and SDS in both groups were significantly lower than those before treatment.At the end of 8 weeks and 24 weeks after treatment,the scores of HAMD-17 cognitive impairment,PDQ-D and SDS in the study group were significantly lower than those in the control group.4.At the end of 8 and 24 weeks of treatment,the significant effective rate of cognitive impairment(PDQ-D score reduction>50%)in the Vortioxetine group was significantly higher than that in the Escitalopram group(P<0.05).5.Comparison of safety between the two groups:in the whole course of treatment,the incidence of adverse reactions in the Vortioxetine group and Escitalopram group was 15.09%and 19.23%respectively.There was no significant difference between the two groups(P>0.05).By ?2 test,there was no significant difference(P>0.05).The above adverse reactions were all mild,without special treatment,and were tolerated by the patients in a short period of time.Conclusion:1.Both Vortioxetine and Escitalopram can effectively improve the clinical symptoms,social function and cognitive function of patients with depressive disorder.2.Compared with Vortioxetine,Escitalopram is more effective in long-term improvement of depressive symptoms.3.The improvement of social function and cognitive function of patients with Vortioxetine was better than that of Escitalopram.4.Both Vortioxetine and Escitalopram are definitely safe.