在成年人注意力缺陷/多动障碍患者中,结合甲基酸和选择性血清素再吸收抑制剂
Dong Yun Lee1,2, Chungsoo Kim3, Yunmi Shin4
1Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
JAMA network open
|October 9, 2024
概括
甲基酸和选择性血清素再吸收抑制剂 (SSRI) 的组合对于患有多动症和抑郁症的成年人来说是安全的,没有增加不良事件. 这种ADHD治疗与降低头痛风险有关.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床药理学 临床药理学
背景情况:
- 注意缺陷/多动障碍 (ADHD) 在成年人中经常与抑郁症同时发生.
- 甲基酸与选择性血清素再吸收抑制剂 (SSRI) 结合是一种常见的治疗方法,但其在这种人群中的安全性尚未得到充分证实.
研究的目的:
- 评估在被诊断患有多动症和并发性抑郁症的成年人中将SSRI与甲基酸结合使用的安全性.
- 为了比较不同SSRI和甲基酸组合的安全性概况.
主要方法:
- 一项全国性的队列研究利用了2016年至2021年的韩国索赔数据,包括患有多动症和抑郁症的成年人处方甲基化物.
- 倾向性得分匹配 (1:1比) 用于平衡群体之间的混因素:仅含甲基化物与SSRI加甲基化物,以及fluoxetine加甲基化物与escitalopram加甲基化物.
- 考克斯的比例危险回归模型分析了17个主要和次要结果,其中呼吸道感染作为对照结果.
主要成果:
- 只有甲基化物和SSRI加甲基化物组之间没有观察到不良事件风险的显著差异.
- 与仅服用甲基化物组相比,SSRI组表现出较低的头痛风险 (HR,0.50;95% CI,0.24-0.99).
- 在对头对头的比较中,西加甲基酸与高血压和高脂血症的风险相比,西加甲基酸的风险较低.
结论:
- 在患有多动症和并发性抑郁症的成年人中,将SSRI与甲基酸结合使用并不会增加不良事件的风险.
- 这种组合治疗可能会降低头痛的风险.
- 在这种患者群体中,在与甲基酸结合时,西丁可能是优于埃斯基塔洛普拉姆的选择.
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