Effects of escitalopram oxalate plus low-dose trazodone on psychological state and quality of life in patients with treatment-refractory depression.

ABSTRACT

OBJECTIVE: To analyze the effect of escitalopram oxalate (ESC) plus low-dose (LD) trazodone (TRA) on the psychological state and quality of life (QOL) of patients with treatment-refractory depression (TRD). METHODS: In this retrospective study, we selected 111 TRD patients treated in the People's Hospital of Oedos Dongsheng District between February 2019 and February 2021; 54 patients who were treated with ESC were assigned to the control group (the Con) and the remaining 57 patients treated with ESC + LD-TRA were placed into the research group (the Res). The scores of Hamilton Anxiety/Depression Scale (HAMA, HAMD), Generic Quality of Life Inventory (GQOLI), Pittsburgh Sleep Quality Index Scale (PSQI), and Treatment Emergent Signs and Symptoms (TESS), as well as the levels of brain-derived neurotrophic factor (BDNF), S-100B protein (S-100B), and neuron-specific enolase (NSE) were determined before and after intervention. Besides, the curative effect and incidence of adverse reactions were compared. Furthermore, the risk factors affecting treatment ineffectiveness in TRD patients were analyzed by the multivariate Logistic model. RESULTS: Evident reductions were observed in the Res in terms of HAMA, HAMD and PSQI scores and S-100B and NSE levels after intervention. Eight weeks after intervention, the TESS score was significantly reduced in the Res but not significantly different from the Con; while the scores of various dimensions of the GQOIL and the BDNF level were elevated markedly in the Res that were higher than those of the Con. Moreover, the Res presented with an evidently higher overall response rate than the Con. The two groups had no statistical significance in the overall incidence of adverse reactions (fever, irritability, insomnia, nausea, etc.). Based on the multivariate Logistic model analysis, HAMA, HAMD, PSQI, TESS, BDNF, S-100B, NSE, and treatment modality were not independent risk factors for treatment ineffectiveness in TRD patients. CONCLUSIONS: ESC + LD-TRA can significantly improve the psychological status, QOL, sleep quality and neurological function of patients with TRD while improving efficacy and ensuring patient safety.