Effect of second-generation antidepressants on mania- and depression-related visits in adults with bipolar disorder: a retrospective study.
Effect of second-generation antidepressants on mania- and depression-related visits in adults with bipolar disorder: a retrospective study.
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第二代抗抑郁药对双相情感障碍成人躁狂和抑郁相关就诊的影响：一项回顾性研究。
DOI：
10.1111/j.1524-4733.2006.00159.x
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Hansen,RichardA
中科院分区：
文献类型：
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作者：
Fu,AlexZ;Liu,GordonG;Christensen,DaleB;Hansen,RichardA
CATETIVESTo评估第二代抗抑郁药对躁狂症相关和抑郁症相关的办公室访问的成人双相情感障碍. METHODS使用国家管理式医疗索赔数据库，我们回顾性地确定了连续入组的双相情感障碍患者谁有一个新的抗抑郁处方治疗1998年1月至2002年12月。患者在首次使用抗抑郁药单药治疗、情绪稳定剂单药治疗或抗抑郁药-情绪稳定剂联合治疗后至少随访12个月。使用倾向评分匹配的Logit模型来确定治疗类型与12个月内躁狂相关就诊可能性之间的关系。负二项模型和考克斯比例风险模型被用来预测抑郁症相关的就诊次数和首次躁狂或抑郁症相关就诊的时间。与接受情绪稳定剂单药治疗的患者相比，接受抗抑郁剂单药治疗和联合治疗的患者躁狂症相关就诊的可能性没有差异（比值比（OR）分别为0.67（95%置信区间（CI）0.42-1.04）和0.99（95% CI 0.69-1.43））。相同比较的抑郁相关访视次数显著较低，发生率比值分别为0.68（95%CI 0.56-0.82）和0.65（95%CI 0.52-0.81）。第一次躁狂症或抑郁症相关的访问时间的结果提供了类似的indication.CONCLUSIONSecond-generation抗抑郁药与抑郁症相关的访问次数减少，但与躁狂症相关的访问1年内的风险增加。虽然需要更多的工作来确定第二代抗抑郁药治疗双相抑郁症的安全性和有效性，但本研究的证据支持有利的风险-获益特征。
OBJECTIVESTo assess the effect of second-generation antidepressants on mania-related and depression-related office visits for adults with bipolar disorder.METHODSUsing a national managed-care claims database, we retrospectively identified continuously enrolled patients with bipolar disorder who had a new antidepressive prescription treatment between January 1998 and December 2002. Patients were followed for at least 12 months after the date of initial use of antidepressant monotherapy, mood stabilizer monotherapy, or antidepressant–mood stabilizer combination therapy. Logit models with propensity score matching were used to identify the relationship between treatment types and the likelihood of having mania-related visits within 12 months. Negative binomial models and Cox proportional hazard models were used to predict the number of depression-related visits and time to first mania- or depression-related visit.RESULTSPatients on antidepressant monotherapy and combination therapy did not have different likelihoods of mania-related visits compared with those on mood stabilizer monotherapy (with odds ratios (ORs) 0.67 (95% confidence interval (CI) 0.42–1.04) and 0.99 (95% CI 0.69–1.43), respectively). The numbers of depression-related visits for the same comparisons were significantly lower, with incidence rate ratios of 0.68 (95% CI 0.56–0.82) and 0.65 (95% CI 0.52–0.81), respectively. The results of time to first mania- or depression-related visit provided similar indications.CONCLUSIONSecond-generation antidepressant was associated with a decreased number of depression-related visits but was not associated with an increased risk of mania-related visits within a 1-year period. Although more work is needed to establish the safety and efficacy of second-generation antidepressants in treating bipolar depression, the evidence from this study supports a favorable risk–benefit profile.