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目的：探讨米氮平与帕罗西汀治疗老年抑郁症的临床疗效和安全性。方法将80例抑郁症患者随机分为米氮平组和帕罗西汀组，每组40例，分别口服米氮平和帕罗西汀治疗，观察6周。于治疗前后采用汉密顿抑郁量表评定临床疗效，副反应量表评定不良反应。结果治疗后两组汉密顿抑郁量表评分均较治疗前有显著下降（P＜0．01），同期两组评分比较差异无显著性（ P＞0．05）；治疗6周末，米氮平组显效率92．5％，总有效率97．5％；帕罗西汀组分别为90．0％、97．5％，两组显效率、总有效率差异无显著性（ P＞0．05）。两组不良反应均轻微，米氮平组嗜睡、食欲增加、体质量增加发生率显著高于帕罗西汀组，合并苯二氮艹卓类药物应用率显著低于帕罗西汀组（ P＜0．05或0．01）。结论米氮平与帕罗西汀治疗老年抑郁症疗效显著，安全性高，依从性好，可作为治疗老年抑郁症的首选药物在临床推广应用。“,”Objective To explore the efficacy and safety of mirtazapine and paroxetine in the treatment of senile depression .Methods Eighty depression patients were randomly assigned to two groups of 40 ones each and took orally mirtazapine or paroxetine for 6 weeks .Efficacies were assessed with the Hamilton De‐pression Scale (HAMD) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results After treatment the HAMD scores of both groups lowered more signifi‐cantly compared with pretreatment (P0 .05);At the end of the 6th week obvious and total effective rate were respectively 92 .5% and 97 .5% in mirtazapine and 90 .0% and 97 .5% in paroxetine group ,which showed no significant differences (P>0 .05) .Adverse reactions of both groups were mild ,the incidences of hypersomnia ,hy‐perorexia and weight gain were significantly higher and use rate of combination with benzodiazepines lower in mirtazapine than in paroxetine group (P<0 .05 or 0 .01) .Conclusion Both mirtazapine and paroxetine are effective ,have higher safety and better compliance ,and could serve as choice drugs for senile depres‐sio n .