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药物诱导的体重变化与常见的抗抑郁药治疗:一个向试验仿真研究
Joshua Petimar1, Jessica G Young1, Han Yu2
1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (J.P., J.G.Y.).
Annals of internal medicine
|July 1, 2024
概括
布普罗与常见抗抑郁药中体重增加最少有关,而埃斯基塔洛普拉姆,帕洛克塞丁和杜洛克塞丁则显示体重增加较高. 临床医生在开抗抑郁药时应考虑体重变化.
科学领域:
- 药理学和临床治疗学
- 比较有效性研究比较有效性研究
- 心理健康治疗的结果
背景情况:
- 抗抑郁药被广泛处方,但对一线治疗的体重变化进行比较的数据有限.
- 了解重量差异效应对于患者的坚持和治疗成功至关重要.
研究的目的:
- 为了比较与启动常见的第一线抗抑郁药治疗相关的体重变化.
- 使用现实世界电子健康记录数据模拟目标试验.
主要方法:
- 一项观察性队列研究分析了183,118名患者在24个月内使用电子健康记录 (EHR) 数据.
- 开始使用塞特拉林,西塔洛普拉姆,埃斯基塔洛普拉姆,弗洛克塞,帕洛克塞,布罗皮昂,杜洛克塞或文拉法辛的人口水平影响是使用反向概率权衡来估计的.
主要成果:
- 布普罗与体重增加最少 (比塞特拉林少0.22公斤) 和显著体重增加的风险降低有关.
- 埃斯基塔洛普拉姆,帕洛克和杜洛克的平均体重增加较高 (比塞特拉林增加0.34-0.41公斤),体重增加的风险增加.
- 在六个月的时间里,药物坚持率有所不同,杜洛西丁为28%,布罗为41%.
结论:
- 在一线抗抑郁药中,平均体重变化存在小但显著的差异.
- 布鲁显示出最有利的体重概况,而其他某些药物则与更大的体重增加有关.
- 这些发现表明,临床医生在选择抗抑郁药治疗时应该考虑潜在的体重影响.
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