| Objective To observe the therapeutic effect of escitalopram on severe depressed patients accompany with
insomnia. Methods We chose compatible patients through consulting medical history, physical examination, laboratory
examination, Pittsburgh sleep quality index (PSQI) and Hamilton Depression Scale (HAMD) et al, and the patients were graded
by index scale(ISI), Montgomery Depression Scale(MADRS), generalized anxiety scale(GAD-7) and the Clinical Global
Impression Scale(CGI) the previous day, in addition began to record sleep diary. Meanwhile Patients were given oral
escitalopram after breakfast, the initial dosage was 5～10 mg/d, recorded sleep diary in the morning and evening which gave
researcher in the next visit. The clinical follow-up on the seventh day, fourteenth day and thirtieth day respectively, and graded by
ISI, MADRS, PSQI GAD-7 and CGI again, including record adverse events also. The dosage of escitalopram was adjusted
according to therapeutic effect, the highest dosage was 20mg/ day. ANOVA analysis of demographic characteristics, vital signs
and scale based on SSPS10.0. Results In 160 cases of patients, 67 males, mean age(42±12)years old, 93 females, mean
age(41±12)years old. In the four visit, weight, pressure and heart rate hadno statistically difference. The scores of PSQ, ISI,
MADRS, GAD-7 and CGI decreased, andeach of the two visits had significant difference. The therapeutic effect was obvious
after the seventh day, which continued to strengthen on the thirtieth day. The dosage of escitalopram gradually increased from (9.7±1.5) mg to (14.8 ± 4.0) mg, and in (14.8 ± 4.0) mg level, it played an ideal effect, only 2 patients had a little discomfort of
dizziness and palpitation. Conclusion Insomnia is the most common symptom of depressed patients, escitalopram can improve
the symptom of severe depressed patients, and their insomnia furthermore. This study suggests that the best effective dose of
escitalopram in the treatment of severe depressive patients with insomnia is about 15mg/day. |
