在抑郁症中使用抗抑郁药物治疗预防复发:系统性审查
John R Geddes1, Stuart M Carney, Christina Davies
1Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK. john.geddes@psych.ox.ac.uk
Lancet (London, England)
|February 28, 2003
概括
与停止治疗相比,持续抗抑郁药治疗显著降低了70%的抑郁复发风险. 这种益处是巨大的,特别是对于复发性抑郁症患者,尽管最佳治疗持续时间需要进一步研究.
科学领域:
- 精神病学是一个精神病学.
- 临床药理学 临床药理学
背景情况:
- 抗抑郁药物在实现急性抑郁发作缓解方面是有效的.
- 预防复发是管理抑郁障碍的一个关键方面.
研究的目的:
- 系统地审查关于抗抑郁药治疗最佳持续时间的证据,以防止抑郁症患者的复发.
- 量化持续抗抑郁药治疗与停止治疗相关的风险降低.
主要方法:
- 进行了随机对照试验 (RCT) 的系统概述.
- 在多个数据库中进行了搜索,包括Medline,Embase,Cinahl,PsycLIT,Psyndex和Lilacs.
- 来自31个涉及4410名参与者的RCT的数据被组合起来进行分析.
主要成果:
- 与停止治疗相比,持续抗抑郁药治疗将复发的几率降低了70% (几率比率为0.30,95% CI为0.22-0.38).
- 平均复发率在安慰剂组为41%,而在活性治疗组为18%.
- 保护作用持续了长达36个月,尽管需要证实更长期的证据. 在抗抑郁药组中观察到更高的断学率 (18%对15%).
结论:
- 抗抑郁药可以显著降低抑郁症复发的风险.
- 持续抗抑郁药物治疗对许多患者,特别是那些患有复发性抑郁症和更高复发风险的患者,有很大的益处.
- 需要进一步的研究来确定最佳的治疗持续时间,并包括代表性不足的患者群体.
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