一般的な不安障害の薬理学的治療法:体系的なレビューとネットワークメタ解析
April Slee1, Irwin Nazareth1, Paulina Bondaronek1
1Department of Primary Care and Population Health, University College London, London UK.
Lancet (London, England)
|February 5, 2019
まとめ
このネットワークメタアナリシスでは,ドロキセチン,プレガバリン,ヴェンラファキシン,エシタロプラムを含む,一般的な不安障害に対するいくつかの効果的な薬理学的治療法が見つかりました. クエチアピンのような薬は効いたが 耐受性が悪かったため 薬の厳選が必要である.
科学分野:
- 薬理学について
- 精神科
- 臨床試験
背景:
- 一般的な不安障害 (GAD) は重大な機能障害を引き起こす.
- 薬理学的治療は,コストとリソースの制約のために,心理学的代替治療よりも好ましいことが多い.
- 利用可能なGAD薬の比較データは限られている.
研究 の 目的:
- 一般的な不安障害 (GAD) に対する様々な薬学的薬剤の有効性と許容性を体系的に検討し比較する.
- GADの管理における治療決定を導くために臨床医に比較情報を提供する.
主な方法:
- GADの成人患者によるランダム化対照試験の体系的レビューとネットワークメタ解析.
- 複数のデータベースとレジストリから特定されたプラセボとアクティブコントロール試験の含有
- 評価された主なアウトカムは,有効性 (ハミルトン不安スケールのスコアの変化) と受容性 (試験中止) でした.
主要な成果:
- ドゥロキセチン,プレガバリン,ヴェンラファクシン,エシタロプラムはプラセボよりも優れた有効性を示し,良好な受容性を示した.
- ミルタザピン,セルトラリン,フルオキセチン,バスピロン,アゴメラチンも有効でしたが,サンプルサイズが小さかったため制限がありました.
- クエチアピンは高い有効性を示したが,耐受性が悪かった. パロキセチンとベンゾジアゼピンは有効だったが,プラセボと比較して耐受性が悪かった.
結論:
- 一般的な不安障害には,さまざまな薬剤クラスで複数の効果的な薬理学的治療法があります.
- この研究は,GADの薬剤療法に関する貴重な比較データを提供します.
- 初期治療の失敗は必ずしも薬理学的アプローチを放棄させるべきではない.
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