成年人抑郁症的Esketamine治疗方法:PRISMA系统审查和元分析
Konstantinos N Fountoulakis1, Athanasios Saitis1, Alan F Schatzberg1
13rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (Fountoulakis, Saitis); Stanford University Mood Disorders Center and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford (Schatzberg).
The American journal of psychiatry
|January 29, 2025
概括
鼻腔内胺对治疗耐药性抑郁症具有适度的益处,但对自杀倾向没有显著影响. 长期影响和滥用潜力需要仔细考虑.
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.
- 药理学 药理学是指药理学的学科.
背景情况:
- 鼻内注射的斯基坦胺已被批准用于治疗耐药性重度抑郁症 (TRD),并具有急性自杀念头.
- 有效性和安全性数据需要进行系统审查和元分析.
研究的目的:
- 系统地审查和分析鼻内胺对抑郁症和自杀倾向的疗效.
- 为了评估与鼻腔内施以斯基坦胺治疗相关的副作用.
主要方法:
- 在MEDLINE的系统文献搜索中使用关键字"esketamine" (2024年3月24日).
- 在研究选择中应用了PRISMA方法.
- 使用R (版本4.3.3) 和METAFOR包进行统计分析.
主要成果:
- 87件物品包括在最初确定的1115件物品中.
- 在 2-4 周对抑郁症有微弱但显著的积极影响 (效果大小为 0.15-0.23),与非典型抗精神病药物增强相比.
- 在任何时间点都没有观察到对自杀倾向的显著影响;灵敏度分析证实了这些发现.
结论:
- 埃斯凯特胺对TRD的附加疗效是适度的,类似于其他增强策略.
- 对自杀倾向本身没有显著的有效性.
- 关于滥用潜力,未知的长期影响和令人担忧的安全信号 (死亡,新出现的自杀倾向) 的担忧需要谨慎和进一步调查.
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