抗抑郁药停用症状的发生率:系统性审查和元分析
Jonathan Henssler1, Yannick Schmidt2, Urszula Schmidt2
1Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Cologne, 50937 Cologne, Germany; Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, St Hedwig Hospital, Berlin, Germany.
The lancet. Psychiatry
|June 8, 2024
概括
停用抗抑郁药物症状发生在停用药物的患者中约有31%,而安慰剂患者中约有17%. 这次元分析量化了这些症状,以告知临床实践.
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
- 基于证据的医学基于证据的医学.
背景情况:
- 抗抑郁药停用症状 (ADS) 是一个日益严重的临床问题.
- 量化ADS的发生率对于患者和临床医生的指导至关重要.
- 之前对ADS发病率的估计缺乏全面的数据.
研究的目的:
- 系统地评估抗抑郁药停用症状的发生率.
- 为了比较抗抑郁药和安慰剂组之间的ADS发病率.
- 确定影响ADS频率和严重程度的因素.
主要方法:
- 在Medline,EMBASE和CENTRAL的系统文献搜索到2022年10月.
- 包括随机对照试验,对照试验和观察性研究.
- 随机效应元分析,以汇集整体和严重症状的发病率数据.
主要成果:
- 至少发生一次ADS的发生率为31%的抗抑郁药与17%的安慰剂.
- 抗抑郁药的严重ADS发生率为2.8%,而安慰剂为0.6%.
- 特定的抗抑郁药物 (德斯文拉法辛,文拉法辛,伊米普拉胺,埃斯基塔洛普拉姆) 显示症状的频率更高.
结论:
- 停用抗抑郁药的症状影响大约15%的患者,考虑到安慰剂效应.
- 结果为临床医生和患者提供有关ADS可能程度的信息,旨在减少警报.
- 需要进一步的研究来探索影响症状发生的未知因素.
相关概念视频
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
369
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
369
Antidepressant Drugs: MAOIs and Other Agents
220
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
220
Antidepressant Drugs: Overview
444
Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
444
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
122
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
122
Depression: Overview
238
Depression is a prevalent mental illness marked by persistent sadness and lack of interest in previously enjoyable activities. It can take several forms, including major depression, persistent depressive disorder, and bipolar I and II disorders. Symptoms range from emotional changes like chronic worry to physical changes like sleep disturbances and suicidal thoughts. From a neurobiological perspective, depression is believed to be triggered by abnormalities in the brain's prefrontal cortex,...
238
Depressive Disorders: MDD and Dysthymia
99
Depressive disorders are a group of mental health conditions characterized by pervasive feelings of sadness, diminished pleasure in life, and a significant impact on daily functioning. These conditions are most prevalent in individuals during their 30s and affect women at twice the rate of men. Contrary to popular belief, younger individuals are generally more susceptible to these disorders than older adults. Two key types of depressive disorders include Major Depressive Disorder (MDD) and...
99


