Effect and safety of agomelatine and paroxetine in the treatment of depression
Objective To explore the effect and safety of agomelatine and paroxetine in patients with depression.Methods A total of 120 patients with depression treated in Wenzhou Seventh People's Hospital were enrolled as the research objects between October 2021 and October 2023.According to the order of admission order in computer system,and the randomly serial number generated by software,they were divided into control group(60 cases,paroxetine)and observation group(60 cases,agomelatine)according to odd and even numbers.The curative effect,scores of Hamilton Depression Scale(HAMD)and Clinical Global Impressions-Severity of Illness Scale(CGI-S),amplitude of low-frequency fluctuation(ALFF)in different brain areas and related adverse reactions in the two groups were compared.Results The total response rate was higher in observation group than control group(93％vs 86％,x2=1.415,P=0.234).After treatment,there were no significant differences in HAMD score,reduction rate of HAMD score or CGI-S score between the two groups(t=1.485,P=0.141;t=1.494,P=0.138;t=0.991,P=0.324).After treatment,ALFF values at right middle frontal gyrus,right posterior cingulate gyrus,left anterior insular lobe and tegmentum of left inferior frontal gyrus were decreased in control group(GRF correction,voxel level P＜0.01,mass level P＜0.05,voxel value＞21),while ALFF values at orbital part of left inferior frontal gyrus,left inferior parietal lobe and upper edge of right parietal lobe were increased in observation group(GRF correction,voxel level P＜0.01,mass level P＜0.05,voxel value＞21).The incidence of adverse reactions was lower in observation group than control group(18％vs 39％,x2=6.024,P=0.014).Conclusion The antidepressant effect of agomelatine and paroxetine is comparable,which both can significantly improve depression and relieve disease severity.However,agomelatine has lower incidence of adverse reactions.The two drugs may play an antidepressant effect by affecting activities of different brain areas.
Depressive disorderParoxetineTranscranial magnetic StimulationAgomelatineBrain functional activity
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