| Background:Depression is a type of mood disorder caused by various reasons and characterized by a significant and persistent depression of mood.Some patients might cut,suicide,and even died.The World Health Organisation reports that depression could become the second biggest disease after heart diease by the end of the year.As the increasing incidence of depression,the treatment and prognosis become more and more important.Escitalopram is an antidepressant in the category of 5-hydroxytryptamine reuptake inhibitors(SSRIs)and duloxetine is an antidepressant in the category of selective noradrenaline reuptake inhibitors(SNRIs),both of which are recommended as class A drugs in the Chinese guidelines for the prevention and treatment of depressive disorders(second edition)for first-line treatment of depression.This study evaluating the response rate after 1-week treatment and 2-week treatment,the safety of adverse drug reactions such as constipation,dry mouth,nausea,and analysis of female patients and elder patients with depression,in order to provide evidence-based basis for escitalopram and duloxetine on the clinical treatment of depression.Objective:To systematically compare the efficacy and safety of escitalopram and duloxetine in the treatment of depression through a meta-analysis.Methods:By searching CNKI,Chinese science and technology journal database,Wanfang database,PubMed,EMBASE and The Cochrane Library database we have retrievalled the randomized controlled trials of comparing duloxetine and escitalopram on the treatment of depression,according to the strict include and exclude standard of literature screening.Conduct the risk of bias assessment and extract data,then using Revman 5.3 software for data processing.Results:A total of 31 randomized controlled trials were included in this study,with a total of 3569 patients,including 1783 in the escitalopram group(test group)and 1786 in the duloxetine group(control group).The efficacy indexes of escitalopram vs duloxetine were:(1)the response rate,including 1-week response rate,2-week response rate,4-week response rate,6-week response rate and 8-week response rate;(2)recovery rate,including 4-week recovery rate,6-week recovery rate and 8-week recovery rate.The results of meta-analysis showed that there was no statistical difference in the response rate and recovery rate of depression between escitalopram and duloxetine.The incidence of adverse reactions:constipation[P=0.0001,RR=0.55,95%CI(0.41,0.73)],dry mouth[P=0.0001,RR=0.61,95%CI(0.49,0.76)],nausea[P=0.00001,RR=0.58,95%CI(0.48,0.71)],decreased appetite[P=0.01,RR=0.71,95%CI(0.53,0.93)],sweating[P=0.03,RR=0.70,95%CI(0.51,0.97)],the results of adverse reactions above had no significant differences(P<0.05).There were no statistically significant differences in the incidence of adverse reactions such as fatigue,fatigue,insomnia,drowsiness,dizziness and headache(P?0.05).There were no statistically significant differences in the response rate and recovery rate of escitalopram and duloxetine in elderly and female patients with depression.The efficacy of escitalopram and duloxetine were similar by different dosage groups and different country groups.Conclusion:Compared with duloxetine,escitalopram showed no difference in 1-week response rate,2-week response rate,4-week response rate,6-week response rate,8-week response rate,4-week recovery rate,6-week recovery rate and 8-week recovery rate.Escitalopram is superior to duloxetine in the incidence of adverse reactions such as constipation,dry mouth,nausea,decreased appetite and sweating.The incidence of adverse reactions in fatigue,insomnia,lethargy,dizziness and headache were similar.In elderly patients and women patients with depression,the efficacy of escitalopram and duloxetine were similar.The efficacy of escitalopram and duloxetine were similar by different dosage groups and different country groups. |
PDF Full Text Request