| ABSTRACT Objective: To assess the efficacy and safety of escitalopram and mirtazapine in senile depression. Methods:PubMed, Embase, Cochrane Library (2017 No.1), SinoMed, CNKI, WanFang Data and VIP database were electronically searched to collect randomized controlled trials (RCTs) of senile depression treated by escitalopram versus mirtazapine from inception to January 2018. Two researchers independently screened literatures, extracted data and assessed risk of bias of included studies. Then Meta analysis was performed by RevMan 5.3 software. Results:Five RCTs involving 294 patients were included. The results of Meta analysis showed that: ①There was no statistically significant difference in the efficacy of patients in the escitalopram group and the mirtazapine group after 6 weeks of treatment (OR=0.94, 95%CI 0.43 to 2.06, P=0.87). At the 1, 2, 4, 6 weeks of treatment, the Hamilton depression scale (HAMD) between the escitalopram group and the mizapine group were not statistically significant (P＞0.05). ②The incidence rate of three adverse drug reactions such as somnolence, headache/dizziness, weight change in the escitalopram group were lower than that of mirtazapine group, the difference was statistically significant (weight change: RR=0.36, 95%CI 0.14 to 0.95, P=0.04; somnolence: RR=0.16, 95%CI 0.06 to 0.44, P=0.000 4; headache/dizziness:RR=0.47, 95%CI 0.24 to 0.91, P=0.03). Conclusion:The two groups have similar efficacy. In common adverse reactions, mirtaxapine easily causes somnolence, weight change and headache/dizziness. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion. |
