贝塔抑制剂治疗和抑郁症,疲劳和性功能障碍的症状
Dennis T Ko1, Patricia R Hebert, Christopher S Coffey
1Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT 06520-8025, USA.
JAMA
|July 16, 2002
概括
贝塔抑制剂治疗与显著的抑郁症状无关. 虽然疲劳和性功能障碍的风险很小,但它们应该与β抑制剂已证明的心脏益处进行权衡.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 贝塔抑制剂疗法在心脏病患者中提供了经过验证的死亡率益处,但由于对副作用的担忧,其使用不足.
- 通常引用的副作用包括抑郁症,疲劳和性功能障碍.
研究的目的:
- 量化审查随机试验,以确定β抑制剂与抑郁症状,疲劳和性功能障碍之间的关联.
- 评估在心肌梗塞,心力衰竭和高血压中使用β抑制剂是否与这些不良事件的风险增加有关.
主要方法:
- 1966年至2001年间发表的针对心血管疾病的β-阻断剂随机,安慰剂对照试验的系统综述.
- 包括的试验要求至少100名患者和6个月的随访. 关于抑郁症状,疲劳和性功能障碍的数据来自15个符合条件的试验,涉及超过3.5万名受试者.
主要成果:
- 贝塔抑制剂治疗没有显著增加抑郁症状.
- 观察到疲劳 (每1000名患者中的18名/年) 和性功能障碍 (每1000名患者中的5名/年) 的小但显著增加.
- 根据脂质溶解度,不良反应的风险并没有差异;早期代β抑制剂的疲劳风险比后期代更高.
结论:
- 临床试验数据不支持与β-阻断剂治疗有抑郁症,疲劳或性功能障碍的实质性风险.
- 观察到的疲劳和性功能障碍风险的小幅增加是轻微的,应该与β-阻断剂的显著益处一起考虑.
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