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贝叶斯对一项关于治疗抑郁症的试验 psilocybin 与 escitalopram 的重新分析
Sandeep M Nayak1, Bilal A Bari2, David B Yaden1
1Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Psychedelic medicine (New Rochelle, N.Y.)
|June 20, 2023
概括
这种贝叶斯式再分析表明,在重大抑郁障碍 (MDD) 中,psilocybin的表现优于escitalopram,但不是有意义的. псилоцибин治疗显示非劣于埃斯基塔洛普拉姆,支持进一步的研究.
科学领域:
- 精神病学和神经科学 精神病学和神经科学
- 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:
- 大型抑郁症 (MDD) 是全球导致残疾的主要原因.
- 目前用于MDD的治疗方法,如埃斯基塔洛普拉姆,在有效性和耐受性方面存在局限性.
- 一种迷幻化合物psilocybin已经显示出对抑郁症的潜在治疗效果.
研究的目的:
- 对一项临床试验进行贝叶斯式再分析,比较西 (COMP360) 与治疗MDD的埃斯基塔洛普拉姆.
- 为以前不确定的频率分析结果提供更有信息的解释.
- 评估相对有效性和psilocybin的非劣等性与埃斯基塔洛普拉姆相比.
主要方法:
- 重新分析了一项双臂,双盲,安慰剂对照试验,涉及59名患有MDD的患者.
- 采用了贝叶斯统计方法,包括贝叶斯因子和怀疑的先验.
- 使用快速抑郁症征兆学自我报告清单 (QIDS-SR-16) 和其他抑郁症量表 (HAMD-17,MADRS,BDI-1A) 来衡量结果.
主要成果:
- 贝叶斯分析表明,在QIDS-SR-16上,psilocybin优势的证据是不确定的,但在HAMD-17,MADRS和BDI-1A上有强有力的证据.
- 临床上有意义的差异证据在HAMD-17上偏好了psilocybin,但在其他尺度上没有.
- 非常强有力的证据支持psilocybin在所有措施中与esitalopram相比没有劣势.
结论:
- 在这项试验中,psilocybin表现出优于escitalopram的优势,尽管在所有措施上并非具有临床意义.
- 在治疗MDD方面,psilocybin疗法很可能与埃斯基塔洛普拉姆无差.
- 这些发现需要进一步调查西与已知的抑郁症治疗相比的疗效.
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