Treatment outcomes of depression: the pharmacogenomic research network antidepressant medication pharmacogenomic study.
Treatment outcomes of depression: the pharmacogenomic research network antidepressant medication pharmacogenomic study.
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DOI：
10.1097/jcp.0000000000000099
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发表时间：
2014-06
影响因子：
2.9
通讯作者：
Katzelnick DJ
中科院分区：
文献类型：
--
作者：
Mrazek DA;Biernacka JM;McAlpine DE;Benitez J;Karpyak VM;Williams MD;Hall-Flavin DK;Netzel PJ;Passov V;Rohland BM;Shinozaki G;Hoberg AA;Snyder KA;Drews MS;Skime MK;Sagen JA;Schaid DJ;Weinshilboum R;Katzelnick DJ
背景：选择性5 -羟色胺再摄取抑制剂（SSRIs）治疗重度抑郁症（MDD）的有效性存在争议。目的报告非精神病性重度抑郁症患者的临床结果，并与STAR* D研究结果进行比较，为SSRIs的有效性提供指导。方法采用西酞普兰/艾司西酞普兰治疗8周。采用抑郁症状快速量表-临床医师评定量表（QIDS-C16）和17项汉密尔顿抑郁评定量表对抑郁进行测量。结果随访1次以上的患者QIDS-C16≥5分的缓解率为45.8%，缓解率为64.8%，QIDS-C16评分改善5分以上的达79.9%。药物基因组学研究网络抗抑郁药物基因组学研究对象比STAR* D研究对象更有可能获得反应。经人口统计学因素调整后，两组的回复率差异无统计学意义。当报告不良反应负担时，60.5%的受试者在4周的访问中报告无损害，31.7%的受试者报告有轻微至轻度损害，7.8%的受试者报告有中度至重度负担。结论考虑使用SSRI治疗重度抑郁症的患者可以预期症状改善的概率很高（79.9%），而症状恶化的概率很低。基线严重程度较低的患者获得缓解的可能性较高。药物基因组学研究网络抗抑郁药物药物基因组学研究在控制了研究之间的差异后，重复了STAR* D研究第一阶段的许多发现。
BackgroundThe effectiveness of selective serotonin reuptake inhibitors (SSRIs) in patients with major depressive disorder (MDD) is controversial.AimsThe clinical outcomes of subjects with nonpsychotic MDD were reported and compared with the Sequenced Treatment Alternatives to Relieve Depression (STAR* D) study outcomes to provide guidance on the effectiveness of SSRIs.MethodsSubjects were treated with citalopram/escitalopram for up to 8 weeks. Depression was measured using the Quick Inventory of Depressive Symptomatology—Clinician Rated (QIDS-C16) and the 17-item Hamilton Depression Rating Scale.ResultsThe group of subjects with at least 1 follow-up visit had a remission (QIDS-C16≤ 5) rate of 45.8% as well as a response (50% reduction in QIDS-C16) rate of 64.8%, and 79.9% achieved an improvement of 5 points or higher in QIDS-C16 score. The Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study subjects were more likely to achieve a response than STAR* D study subjects. After adjustment for demographic factors, the response rates were not significantly different. When reporting the adverse effect burden, 60.5% of the subjects reported no impairment, 31.7% reported a minimal-to-mild impairment, and 7.8% reported a moderate-to-severe burden at the 4-week visit.ConclusionsPatients contemplating initiating an SSRI to treat their MDD can anticipate a high probability of symptom improvement (79.9%) with a low probability that their symptoms will become worse. Patients with lower baseline severity have a higher probability of achieving remission. The Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study replicates many findings of the first phase of the STAR* D study after controlling for the differences between the studies.