Meta-analysis of effect and safety of Escitalopram and Paroxetine in the treatment of post-stroke depression
FANG Zhi-rong1 LU Jin-xin1 WAN Fang2 YIN Yan-wei
1. The Second Department of Internal Medicine, Eastern District Naval Hospital of PLA, Zhejiang Province, Zhoushan 316000, China;
2. Department of Quality Management, Air Force Characteristic Medical Center, Beijing 100080, China;
3. Department of Neurology, Air Force Characteristic Medical Center, Beijing 100080, China
Abstract：Objective To systematically evaluate the effect and safety of Escitalopram and Paroxetine in the treatment of post-stroke depression (PSD). Methods The randomized controlled trials (RCTs) of Escitalopram and Paroxetine for treating PSD were retrieved in PubMed, Cochrane Library, Wanfang database, CBM, CNKI, Google Scholar, Baidu Scholar published from the establishment of the database to November 2019 by computer. After extracting the data and evaluating the quality, the RevMan 5.3 software was used to conduct Meta-analysis on the data. Results Finally 9 RCTs were included, involving 765 patients. The results of Meta-analysis showed that the Hamilton depression rating scale(HAMD) score in the experimental group decreased more than that in the control group after 1 week of treatment, and the difference was statistically significant (SMD=-0.83, 95%CI[-1.06, -0.60], Z=7.05, P＜0.000 01). After 2, 4, 6 or 8 weeks of treatment, there were no significant differences in HAMD scores between the two groups (P＞0.05). There was no statistically significant difference in the effective rate between the two groups after 6 or 8 weeks of treatment (RR=1.03, 95%CI[0.98, 1.09], Z=1.12, P=0.26). The incidence rates of dry mouth, nausea, headache, and constipation in the experimental group were lower than those in the control group, and the differences were statistically significant (P＜0.05). Conclusion Escitalopram has the same effect as Paroxetine in the treatment of PSD, but Escitalopram has a faster onset.
方志荣；陆金鑫；万方；尹延伟. 艾司西酞普兰与帕罗西汀治疗脑卒中后抑郁有效性和安全性的Meta分析[J]. 中国当代医药, 2020, 27(28): 17-20转32.
FANG Zhi-rong； LU Jin-xin； WAN Fang； YIN Yan-wei. Meta-analysis of effect and safety of Escitalopram and Paroxetine in the treatment of post-stroke depression. 中国当代医药, 2020, 27(28): 17-20转32.
Bilge C，Kocer E，Kocer A，et al.Depression and functional outcome after stroke the effect of antidepressant therapy on functional recovery[J].Eur J Phys Rehabil Med，2008，44（1）：13-18.
Feigin VL，Barker-Collo S，Krishnamurthi R，et al.Epidemiology of ischaemic stroke and traumatic brain injury[J].Best Pract Res Clin Anaesthesiol，2010，24（4）：485-494.
[16]
Williams LS，Ghose SS，Swindle RW.Depression and other mental health diagnoses increase mortality risk after ischemic stroke[J].Am J Psychiatr，2004，161（6）：1090-1095.
[17]
Gao HQ，Zhu HY，Zhang YQ，et al.Reduction of cerebrospinal fluid and plasma serotonin in patients with poststroke depression：A preliminary report[J].Clin Invest Med，2008，31（6）：E351-E356.
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