A Randomized Controlled Study On The Treatment Of First-episode Depression By Agomelatine And Escitalopram

Background:Depression is a common emotional disorders diseases,with significant and lasting low mood,interest and the decline in energy as the main characteristics,have trouble concentating,reduced memory and reduce appetite,sleep disorders,and even self-injury and suicidal behavior syndrome,caused by the interaction of many factors.It’s social function of the patients with severe impact,has a serious threat to human life and health.At present,depression is mainly treated by drug therapy.It is of great importance to select reasonable drugs for patients with depression.Currently,the first-line drug to treat depression is selective serotonin reuptake inhibitor(SSRIs),and escitalopram is a commonly used selective serotonin reuptake inhibitor in clinical practice.Agomelatin is the first approved antidepressant for non-monoamine transmitter system,which is a melatonin receptor agonist and 5-HT2c receptor antagonist,and belongs to a new type of antidepressant.Objective:To explore the clinical efficacy and safety of agomelatine and escitalopram in the treatment of primary depression.Methods:From March 2018 to October 2018,60 patients with first-episode depression admitted to the outpatient department of psychology of Binzhou Medical University Hospital were included in the research object,randomly divided into control group and research group,30 cases each.The control group was treated with escitalopram alone,with a starting dose of 5mg/d,once a day,oral administration after breakfast,and according to the need of the disease to adjust the drug dose,maximum dose not more than 20mg/d.The study group was treated with agomelatin alone,with the inital dose of 25mg/d,once a day,oral administration before bedtime,and appropriate adjustment to 50mg/d as required.The course of treatment was 8 weeks,during which no other antidepreeeant or antipsychotic drugs were used in either group.To evaluate the therapeutic effect,Hamilton Depression Scale(HAMD-17)and Clinical Efficacy General Evaluation Scale(CGI)were measured at the weekends before treatment,1 weekend after treatment,2 weekend,4 weekend and 8 weekend,respectively.TESS was used to evaluate the safety of drug.SPSS 19.0 statistical software was used for statistical analysis of the data.Results:1.Evaluation results of therapeutic effect:(1)HAMD scores of the control group at the first weekend after treatment showed no statistically significant difference from those before treatment(P>0.05),and HAMD scores at the second weekend,the fourth weekend and the eighth weekend showed significant difference from those before treatment(P≤0.05).There were statistically significant differences(P≤0.05)between the study groups at weekend 1,weekend 2 and weekend 4 after treatment and before treatment,but no statistically significant differences(P>0.05)between the groups at weekend 8 and weekend 4 after treatment.(2)HAMD scores of the control group and the study group at the same time point were statistically significant(P≤0.05).(3)At the end of 4 weeks,the effective rate of drug in the control group was 83.8%,and that in the study group was 60%,and the difference was statistically significant(P≤0.05).At the end of 8 weeks,the effective rate of the control group was 90%,and that of the study group was 73.3%.While the control group is higher than the study group,but the difference between the two groups has no statistical significance(P>0.05).2.Evaluation results of drug safety:During the treatment period,there were no significant Changes in blood routine,renal function and electrocardiogram.During the treatment,control the main adverse reactions were nausea,dizziness,headache,diarrhea,the study of adverse reactions were mainly characterized by dizziness,constipation and abnormal liver function.Occurs mostly in the early stages of the drug,the symptoms are mild,not do special treatment,as the drug prolonged,and the body’s tolerance increases,reduce to disappear gradually.Control the incidence of adverse reactions was 17.9%,the incidence of study group was 10.3%,while the control group is higher than the study,but the two groups has no significant statistical difference between the incidence of adverse reactions(P>0.05).Conclusion:1.The effect of escitalopram was better than of agrometine at the weekend of 4,and as time goes on,the effect between escitalopram and agrometine was equal at the weekend of 8.2.Escitalopram and agomelatine have higher safety and fewer adverse reactions.