Meta-analysis of major depressive disorder relapse and recurrence with second-generation antidepressants.
Meta-analysis of major depressive disorder relapse and recurrence with second-generation antidepressants.
复制标题
重度抑郁症复发和第二代抗抑郁药复发的荟萃分析。
DOI：
10.1176/ps.2008.59.10.1121
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Lohr,Kathleen
中科院分区：
文献类型：
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作者：
Hansen,Richard;Gaynes,Bradley;Thieda,Patricia;Gartlehner,Gerald;Deveaugh-Geiss,Angela;Krebs,Erin;Lohr,Kathleen
本荟萃分析回顾了第二代抗抑郁药在预防抑郁症复发和在持续和维持治疗期间复发的疗效和有效性数据，分别检索了MEDLINE、EMBASE和PsycINFO、科克伦图书馆和国际药学文摘，检索时间为1980年1月至2007年4月，荟萃分析和观察性研究。两个人独立审查摘要和全文文章，使用结构化的数据摘要形式，以确保一致性的评估和dataextraction.ResultsFour比较试验和23安慰剂对照试验，解决复发或复发预防。比较试验的结果表明，度洛西汀与帕罗西汀、氟西汀与舍曲林、氟伏沙明与舍曲林、曲唑酮与文拉法辛之间无统计学显著差异。第二代抗抑郁药与安慰剂相比的汇总数据表明，随着时间的推移，效应量相对较大。为了预防复发和复发，需要治疗的患者数量为5（95%置信区间为4至6）。随机化前开放标签治疗时间、药物类型和试验持续时间的差异不影响复发率的汇总估计值。在所有的试验中，7%的患者随机分配到接受积极的治疗和5%的患者随机分配到接受安慰剂停止治疗，因为不良事件.ConclusionsThis审查证明了持续和维护阶段的治疗与第二代抗抑郁药的抑郁症的整体效益，并强调需要更多的药物之间的比较差异的研究。（精神科）
ObjectiveThis meta-analysis reviewed data on the efficacy and effective-ness of second-generation antidepressants for preventing major depression relapse and recurrence during continuation and maintenance phases of treatment, respectively.MethodsMEDLINE, EMBASE, and PsycINFO, the Cochrane Library, and International Pharmaceutical Abstracts were searched for the period of January 1980 through April 2007 for reviews, randomized controlled trials, meta-analyses, and observational studies on the topic. Two persons independently reviewed abstracts and full-text articles using a structured data abstraction form to ensure consistency in appraisal and data extraction.ResultsFour comparative trials and 23 placebocontrolled trials that addressed relapse or recurrence prevention were included. Results of comparative trials have not demonstrated statistically significant differences between duloxetine and paroxetine, fluoxetine and sertraline, fluvoxamine and sertraline, and trazodone and venlafaxine. Pooled data for the class of second-generation antidepressants compared with placebo suggested a relatively large effect size that persists over time. For preventing both relapse and recurrence, the number of patients needed to treat is five (95% confidence interval of 4 to 6). Differences in the length of open-label treatment before randomization, drug type, and trial duration did not affect pooled estimates of relapse rates. Across all trials, 7% of patients randomly assigned to receive active treatment and 5% of patients randomly assigned to receive a placebo discontinued treatment because of adverse events.ConclusionsThis review demonstrates the overall benefits of continuation-and maintenance-phase treatment of major depression with second-generation antidepressants and emphasizes the need for additional studies of comparative differences among drugs.(Psychiatric