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抗抑郁药与安慰剂对抗一般性焦虑障碍 (GAD) 的治疗
Katarina Kopcalic1, Justin Arcaro2, Antonio Pinto3
1Department of Epidemiology and Biostatistics, Western University, London, Canada.
The Cochrane database of systematic reviews
|January 29, 2025
概括
与安慰剂相比,抗抑郁药有效地改善了一般性焦虑障碍 (GAD) 的治疗反应,具有类似的整体可接受性. 然而,更多的参与者因副作用而停止抗抑郁药治疗,而不是安慰剂.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 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:
- 泛性焦虑症 (GAD) 是一种普遍存在的精神健康状况,其特点是过度担心,女性的患病率是男性的两倍.
- 抗抑郁药,特别是SSRI和SNRI,是对GAD的常见药理治疗方法,现有证据支持它们比安慰剂更有效.
- 由于新的数据和新型抗抑郁药的引入,需要进行更新的综合性审查,以更好地了解它们的比较有效性和安全性.
研究的目的:
- 与安慰剂相比,评估抗抑郁药在减轻成年人GAD症状方面的有效性.
- 评估抗抑郁药在GAD治疗中的可接受性,重点关注与安慰剂相比的副作用和学率.
主要方法:
- 随机对照试验 (RCT) 和集群RCT的系统审查和元分析.
- 搜索了多个数据库,包括Cochrane,CENTRAL,MEDLINE,Embase,PsycINFO,以及到2022年10月的试验登记.
- 包括初级GAD诊断的成年参与者,但不包括使用二类药物或接受心理治疗的人.
主要成果:
- 抗抑郁药在GAD治疗响应率方面表现出比安慰剂显著的好处 (RR 1.41,高确定性证据),需要治疗的好处数 (NNTB) 为7.
- 抗抑郁药和安慰剂的整体可接受性相似 (RR 1.03),由于缺乏疗效 (NNTB 27),但由于抗抑郁药的不良影响 (NNTH 17) 而减少了学.
- 与安慰剂相比,高确定性证据支持不同类别的抗抑郁药物中的这些发现.
结论:
- 抗抑郁药比安慰剂更有效地改善了成年人患有GAD的治疗反应.
- 虽然整体接受度与安慰剂相当,但抗抑郁药因不良影响导致更多的停药.
- 这次审查对抗抑郁药对GAD的有效性和安全性概况提供了高度的信心,突出了未来研究的领域,特别是关于并发症和方法透明度.
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