Objective To systematically evaluate the efficacy and safety of duloxetine versus paroxetine for adults’ depression. Methods A search was conducted in The Cochrane Library (Issue 6, 2011), Pubmed (1998 to June 2011), CNKI (1998 to June 2011), VIP (1998 to June 2011), CBM (1998 to June 2011), Wanfang database (1998 to June 2011), MEDLINE (1996 to June 2011) and Science Direct (1998 to June 2011). The randomized controlled trials (RCTs) on duloxetine versus paroxetine for adults’ depression were collected. The quality of the included trials was assessed according to the Cochrane Handbook 5.0, and the systematic analysis was conducted by using RevMan 5.0 software. Results Six RCTs involving 1 106 patients were included. The results of meta-analysis showed that: a) After eight-week treatment, there were no significant differences in the effective rate (RR=0.96, 95%CI 0.89 to 1.05, P=0.39) and the final cure rate (RR=0.99, 95%CI 0.86 to 1.15, P=0.93) between the duloxetine and paroxetine groups; b) Adverse reaction: The incidence rate of somnolence in the duloxetine group was lower than that of the paroxetine group (RR=0.63, 95%CI 0.41 to 0.96, P=0.03), oppositely, the incidence rate of abnormal ECG was higher in the duloxetine group (RR=1.91, 95%CI, 1.02 to 3.58, P=0.04). And the other common adverse reactions were not significantly different between the two groups (Pgt;0.05). Conclusion After eight-week treatment, there are no significant differences in the effective rate and the final cure rate between duloxetine and paroxetine. Duloxetine tends easily to induce the abnormal ECG compared with paroxetine.
Objective To evaluate the efficacy and safety of melatonin as an adjuvant therapy for the tumor patients receiving chemotherapy or radiotherapy. Methods Such databases as MEDLINE (1980 to Jan. 2010), The Cochrane Library (Issue 4, 2009), WanFang Data (1980 to Jan. 2010), CBM (1980 to Jan. 2010), CNKI (1980 to Jan. 2010), ELSEVIER ScienceDirect (SDOS, 1980 to Jan. 2010), Nature (1980 to Jan. 2010) and ongoing clinical trials (www.clinicaltrials.gov and www.controlled-trials.com) were searched to collect randomized controlled trials (RCTs). The data were extracted and the quality of the included RCTs was assessed by two reviewers. Then meta-analyses were performed by using Stata 10.1 software. Results Eight RCTs were included. The results of meta-analyses showed that melatonin significantly improved the remission rate for tumor patients (RR=1.98, 95% CI 1.52 to 2.58) and the one-year survival rate (RR=1.90, 95%CI 1.28 to 2.83), and significantly reduced the toxic effects of bone marrow suppression caused by chemotherapy or radiotherapy (RR=0.12, 95%CI 0.06 to 0.27). No reports of adverse events were associated with melatonin. Conclusion The existing evidence reveals that the melatonin, as an adjuvant therapy drug for tumor, plays a certain role in improving disease remission rate, reducing the toxicity of chemotherapy and radiotherapy, and prolonging the life. It requires more high-quality RCTs for further verification because of the limitation of the included studies.