Efficacy and tolerability of second-generation antidepressants in social anxiety disorder.
Efficacy and tolerability of second-generation antidepressants in social anxiety disorder.
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第二代抗抑郁药治疗社交焦虑症的疗效和耐受性。
DOI：
10.1097/yic.0b013e3282f4224a
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发表时间：
2008
影响因子：
2.6
通讯作者：
Lohr,KathleenN
中科院分区：
文献类型：
--
作者：
Hansen,RichardA;Gaynes,BradleyN;Gartlehner,Gerald;Moore,CharityG;Tiwari,Ruchi;Lohr,KathleenN
进行系统回顾和荟萃分析，以评估第二代抗抑郁药在社交焦虑障碍中的疗效和耐受性。通过检索MEDLINE、Embase、The科克伦图书馆、PsychLit和国际药学文摘（1980年1月至2006年10月）确定研究。总结比较证据，并使用网络荟萃分析进行间接比较。只有三个头对头试验被确定;比较试验发现艾司西酞普兰和帕罗西汀之间的疗效差异很小，缓释文拉法辛和帕罗西汀之间的疗效没有统计学显著差异。来自15项安慰剂对照试验的汇总证据表明，艾司西酞普兰[相对获益（RB）1.3; 95%置信区间（CI）1.2-1.5]、帕罗西汀（RB 1.9; 95% CI 1.5-2.3），舍曲林（RB 1.8; 95% CI 1.5-2.2）和文拉法辛（RB 1.7; 95% CI 1.5-1.9）均产生比安慰剂显著更多的应答者;证据支持氟伏沙明优于安慰剂，但不显著（RB 1.5; 95% CI 0.9-2.4）。网络荟萃分析没有显示药物之间的疗效差异。总体而言，相当数量的证据支持艾司西酞普兰、氟伏沙明、帕罗西汀、舍曲林和文拉法辛治疗社交焦虑障碍的疗效。这些药物在疗效上没有差异，尽管它们的不良事件特征有差异。
A systematic review and meta-analysis were conducted to evaluate the comparative efficacy and tolerability of second-generation antidepressants in social anxiety disorder. Studies were identified by searching MEDLINE, Embase, The Cochrane Library, PsychLit, and the International Pharmaceutical Abstracts from January 1980 through October 2006. Comparative evidence was summarized and indirect comparisons were made using network meta-analysis. Only three head-to-head trials were identified; comparative trials found only minimal differences in efficacy between escitalopram and paroxetine, and no statistically significant differences in efficacy between extended-release venlafaxine and paroxetine. Pooled evidence from 15 placebo-controlled trials suggests that escitalopram [relative benefit (RB) 1.3; 95% confidence interval (CI) 1.2–1.5], paroxetine (RB 1.9; 95% CI 1.5–2.3), sertraline (RB 1.8; 95% CI 1.5–2.2), and venlafaxine (RB 1.7; 95% CI 1.5–1.9) all produce significantly more responders than placebo; evidence favored fluvoxamine over placebo but was not significant (RB 1.5; 95% CI 0.9–2.4). Network meta-analysis did not reveal differences in efficacy among drugs. Overall, a fair amount of evidence supports the efficacy of escitalopram, fluvoxamine, paroxetine, sertraline, and venlafaxine in social anxiety disorder. The drugs do not differ in efficacy, although their adverse event profiles do.