在停用抗抑郁药物后稳定的强迫症复发率与维持:系统性审查和元分析
Taro Kishi1, Kenji Sakuma1, Masakazu Hatano1,2
1Department of Psychiatry, https://ror.org/046f6cx68Fujita Health University School of Medicine, Toyoake, Japan.
Psychological medicine
|August 28, 2025
概括
持续服用抗抑郁药对有稳定症状的强迫症患者有好处,大大降低了复发率. 这种方法还导致因不良事件而导致的停药率降低.
科学领域:
- 精神病学和行为科学
- 临床药理学
背景情况:
- 强迫症 (OCD) 症状稳定时,抗抑郁药物维持治疗的最佳持续时间尚不清楚.
- 了解复发风险对于治疗指南至关重要.
研究的目的:
- 系统地审查和元分析随机对照试验,比较强迫症患者的抗抑郁药维持与停止.
- 评估维持治疗对复发率,症状改善和因不良事件而停止治疗的影响.
主要方法:
- 双盲随机化安慰剂对照试验 (DBRPCT) 的系统性审查和对照的元分析.
- 维持组和停止组之间的复发率,强迫症症状改善率和停药率的比较.
- 计算风险比率 (RR),绝对风险降低率 (ARR) 和需要治疗的数量 (NNTB).
主要成果:
- 分析了包括1084名参与者的9项试验.
- 在研究终点上,维持抗抑郁药物显著降低了复发率 (RR=0. 53,ARR=21. 0%,NNTB=5).
- 与停止治疗相比,维持治疗也显示了较低的复发率,并且改善了强迫症症状的控制.
结论:
- 在强迫症患者中,持续服用抗抑郁药物,如果耐受良好,则会降低复发率.
- 维持疗法在预防强迫症复发和改善症状方面具有显著的益处.
- 这些发现支持继续治疗强迫症患者的抗抑郁药.
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