To evaluate the efficacy and side effects of venlafaxine initially combined with tandospirone in the treatment of patients with major depressive disorder, as well as the effects on sexual and cognitive functions.

A total of 90 depression patients who visited the Department of Cardiology of the No. 904 Hospital of The PLA Joint Logistic Support Force from March 2021 to December 2021 were selected. These patients, who met the enrollment criteria, were selected and randomly divided into either a monotherapy group (43 cases) or a combination therapy group (47 cases) using the random number table method. The monotherapy group was treated with venlafaxine combined with placebo, and the combination group was treated with venlafaxine combined with tandospirone. The patients were evaluated with the Hamilton Rating Scale for Depression (HAMD-17), Hamilton Anxiety Scale (HAMA), Arizona Sexual Experience Scale (ASEX), Digit Symbol Substitution Test (DSST), Perceived Deficit Questionnaire for Depression (PDQ-D), and Treatment Emergent Symptom Scale (TESS) at baseline and 1, 2, 4, and 6 weeks after treatment. Paired t-test and independent sample t-test were used to compare the differences in efficacy, sexual function, and cognitive function between the two groups, and the chi-square test was used to compare the differences in the incidence of drug side effects.

HAMD-17 and HAMA scores at 1, 2, 4, and 6 weeks were significantly lower than the baseline values in the combination group (P＜0.05), while HAMD-17 and HAMA scores at 2, 4, and 6 weeks were significantly lower than the baseline values in the monotherapy group (P＜0.05); the HAMD-17 and HAMA scores of the combination group were significantly lower than those of the monotherapy group at 1, 2, 4, and 6 weeks (P＜0.05). The ASEX scores at 4 and 6 weeks were significantly lower than the baseline value in the combination group (P＜0.05), but there was no significant difference in the ASEX scores before and after treatment in the monotherapy group (P＞0.05); the ASEX scores of the combination group were significantly lower than those of the monotherapy group at 4 and 6 weeks (P＜0.05). The DSST and PDQ-D scores at 4 and 6 weeks in the combination group were significantly different from the baseline values (P＜0.05), but there was no significant difference in the DSST and PDQ-D scores before and after treatment in the monotherapy group (P＞0.05); the DSST score of the combination group was significantly higher than that of the monotherapy group at 6 weeks (t=-2.160, P＜0.05), and the PDQ-D score of the combination group was significantly lower than that of the monotherapy group at 4 and 6 weeks (t=2.842 and 4.298, respectively, P＜0.05). There was no evident difference in the incidence of adverse reactions between the two groups (χ²=0.621, P=0.523).

Compared with venlafaxine, the initial combination of venlafaxine with tandospirone in the treatment of patients with major depressive disorder can improve the efficacy, shorten the onset of action, have a good safety profile, and improve sexual and cognitive function.