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在治疗抑郁症时使用psilocybin,SSRI或esketamine的试验中的对照组结果:元分析
Fredrik Hieronymus1,2, Evana López3, Helena Werin Sjögren1,4
1Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
JAMA network open
|July 30, 2025
概括
西在治疗抑郁症方面表现有前途,但其疗效可能被高估. 在psilocybin试验中的对照组比SSRI或esketamine试验中的对照组表现出较小的改善,这表明潜在的偏差.
科学领域:
- 精神病学是一个精神病学.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 赛洛西宾表现出快速和强大的抗抑郁作用,往往超过传统治疗方法.
- 由于功能性解盲和参与者期望,存在对西试验潜在偏差的担忧.
研究的目的:
- 在随机临床试验中比较对照组中抑郁症治疗结果.
- 为了评估与psilocybin,SSRI和esketamine相关的试验中的对照治疗结果.
主要方法:
- 针对主要抑郁症 (MDD) 或治疗耐药性抑郁症 (TRD) 的双盲试验进行了元分析.
- 包括的试验使用了蒙哥马利-阿斯伯格抑郁评分表 (MADRS) 并具有相关的对照臂.
- 来自17项试验的数据 (4种psilocybin,2种esketamine,11种SSRI) 使用随机效应模型进行了聚合.
主要成果:
- 与SSRI和石胺试验中的对照组相比,psilocybin对照组的参与者在MADRS得分上显著减少了改善.
- 在psilocybin对照组中,MADRS反应率较低 (14-23个百分点低于SSRI/胺对照组).
- 与SSRI试验相比,psilocybin和esketamine试验中的中断率要低得多.
结论:
- 在psilocybin试验中的对照治疗结果表明,比SSRI或胺试验的改善更少.
- 西的抗抑郁疗效可能被高估相对于SSRI和胺.
- 需要进一步的研究来解决潜在的偏见,并确认西的真正治疗效果.
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