12种新一代抗抑郁药的比较疗效和可接受性:多种治疗方法的元分析
Andrea Cipriani1, Toshiaki A Furukawa, Georgia Salanti
1Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Italy; Department of Psychiatry, University of Oxford, UK.
Lancet (London, England)
|February 3, 2009
概括
新的分析表明,埃斯基塔洛普拉姆和塞特拉林在重大抑郁症治疗中更有效,耐受性更好. 塞特拉林在中度至重度病例中提供了有利的益处,可接受性和成本平衡.
科学领域:
- 精神病学是一个精神病学.
- 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:
- 传统的元分析对第二代抗抑郁药的疗效结果不一致.
- 为了解决这些不一致性,进行了多种治疗方法的元分析.
- 这项研究侧重于12种新一代抗抑郁药用于大抑郁症.
研究的目的:
- 评估12种新一代抗抑郁药的比较疗效和可接受性.
- 通过包括直接和间接的治疗比较,提供更全面的分析.
- 为了确定最大抑郁症的最佳抗抑郁药选择.
主要方法:
- 从1991年到2007年对117个随机对照试验 (25,928名参与者) 的系统审查.
- 包括单极性主要抑郁症的成年人,接受了布普罗,奇塔洛普拉姆,杜洛克,埃斯基塔洛普拉姆,克塞丁,克萨明,米尔纳西普兰,米尔塔扎平,帕罗克塞丁,雷博克塞丁,塞特拉林或文拉法辛的治疗.
- 主要结局:患者应答率和治疗中止率;治疗意向分析.
主要成果:
- 米尔塔扎平,埃斯基塔洛普拉姆,文拉法辛和塞特拉林的疗效明显高于杜洛克赛丁,弗卢克赛丁,弗卢瓦克萨明,帕洛克赛丁和雷博克赛丁.
- 发现reboxetine的有效性明显低于所有其他测试的抗抑郁药物.
- 埃斯基塔洛普拉姆和塞特拉林表现出最好的可接受性概况,停药的次数明显减少.
结论:
- 在通常处方的抗抑郁药中,有效性和可接受性存在显著的临床差异.
- 埃斯基塔洛普拉姆和塞特拉林在治疗严重抑郁症方面表现出有利的特征.
- 塞特拉林可能是中度至重度重度抑郁症的首选初始治疗方法,因为它具有平衡的益处,可接受性和成本.
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