在双相I型抑郁症中,辅助抗抑郁药维护的持续时间
Lakshmi N Yatham1, Shyam Sundar Arumugham1, Muralidharan Kesavan1
1From the Vancouver Hospital Department of Psychiatry (L.N.Y., G.S., R.W.L.) and the School of Population and Public Health (Y.O., H.W.), University of British Columbia, Vancouver, the Department of Psychiatry, University of Ottawa, Ottawa (G.S.), the Department of Psychiatry, Sunnybrook Health Sciences Centre (A.S.), and the Centre for Addiction and Mental Health (A.R., N.R.), University of Toronto, Toronto, St. Joseph's Healthcare, the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON (B.N.F.), Douglas Hospital, McGill University (A.D., S.B.), and Hôpital Sacré-Coeur, Université de Montréal (A.D.), Montreal, and the Department of Psychiatry, Queen's University, Providence Care, Kingston, ON (R.M.) - all in Canada; the National Institute of Mental Health and Neuro Sciences (S.S.A., M.K., K.R., N.S.M., N.K., Y.C.J.R.) and St. John's Hospital Research Institute (M.V.A.), Bangalore, ASHA Hospital, Hyderabad (M.S.R.), and Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal (R.P.B.) - all in India; the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (D.J.B.); and Seoul National University Bundang Hospital, Seongnam (K.H.), and Seoul National University Hospital (SNUH), Seoul (Y.M.A.) - both in South Korea.
在抑郁症缓解后,持续服用抗抑郁药52周并没有显著地预防双相I型情绪障碍患者的情绪发作. 该研究被提前停止,没有显示出这些药物的明确维护益处.
科学领域:
- 精神病学是一个精神病学.
- 临床神经科学 临床神经科学
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗抑郁药是治疗双相I型精神障碍急性抑郁症的标准.
- 它们在缓解后的长期维持治疗中的作用尚未得到充分证实.
- 这项研究解决了了解双相I型精神障碍中抗抑郁药的长期疗效的差距.
研究的目的:
- 评估维持抗抑郁药疗法与安慰剂在预防双相I型情绪障碍患者情绪发作方面的疗效.
- 评估抑郁症情节缓解后辅助性埃斯基塔洛普拉姆或布洛普里昂XL的长期影响.
主要方法:
- 多站点,双盲,随机,安慰剂对照试验.
- 患有双相I型情绪障碍和最近抑郁症缓解的患者随机分配给52周的抗抑郁药物或8周的安慰剂.
- 主要结局:时间到任何情绪发作;次要结局:时间到躁狂/低躁狂或抑郁复发.
主要成果:
- 由于招募速度缓慢和资金限制,试验被提前停止.
- 在52周和8周组之间的任何情绪事件的时间没有显著差异 (危险比率:0.68,P=0.12).
- 在52周组中观察到抑郁症复发的显著减少 (危险比率:0.43).
结论:
- 在52周内继续服用辅助抗抑郁药物并没有显著地预防双相I型情绪障碍的整体情绪发作复发.
- 这项研究表明,在预防抑郁复发方面存在潜在益处,但整体情绪事件的预防没有统计学意义.
- 试验的早期终止限制了关于维持抗抑郁药疗法的疗效的最终结论.
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