Efficacy of venlafaxine and fluoxetine in patients with major depressive disorder and anxiety symptoms
Objective To investigate the effects of venlafaxine and fluoxetine on somatic symptoms,sleep quality,serum 5-hydroxytryp-tamine(5-HT),cortisol(Cor)and brain-derived neurotrophic factor(BDNF)levels in patients with major depressive disorder(MDD)and anxiety symptoms.Methods A total of 149 patients with MDD and anxiety symptoms who were admitted to the hospital were divided into control group(74 cases)and study group(75 cases)according to random number table method.The control group was treated with fluoxetine,while the study group was treated with venlafaxine combined with fluoxetine.The clinical effect after 8 weeks of treatment,anxiety,depression,somatic symptoms,sleep quality,serum 5-HT,Cor and BDNF levels,and safety were compared between the groups.Results After 8 weeks of treatment,the treatment response rate in the study group was 97.33％,signifi-cantly higher than 87.84％in the control group(P＜0.05).The Hamilton anxiety scale(HAMA)scores,Hamilton depression scale(HAMD)scores,patient health questionnaire-15(PHQ-15)scores,clinical global impression-severity of illness(CGI-S)scores and Pittsburgh sleep quality index(PSQI)scores of the study group were significantly lower than those of the control group(P＜0.01).The levels of 5-HT,norepinephrine(NE)and BDNF in the study group were significantly higher than those in the control group(P＜0.01),while the level of Cor was significantly lower than that in the control group(P＜0.01).There was no statistically significant difference in the incidence of adverse reactions between the 2 groups(P＞0.05).Conclusion Venlafaxine combined with fluoxetine is effective in the treatment of patients with MDD and anxiety symptoms.The combined treatment can effectively improve the patients'anxiety symptoms,depression symptoms,somatic symptoms and sleep quality,improve serum 5-HT and BDNF levels,regulate neurotransmitters,inhibit the excessive secretion of cortisol,and effectively improve nerve cells.
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