Short-course antidepressant therapy reduces discontinuation syndrome while maintaining treatment efficacy in patients with refractory functional dyspepsia: A randomized controlled trial.
Short-course antidepressant therapy reduces discontinuation syndrome while maintaining treatment efficacy in patients with refractory functional dyspepsia: A randomized controlled trial.
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DOI：
10.3389/fpsyt.2022.1063722
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发表时间：
2022
影响因子：
4.7
通讯作者：
Chen, Sheng-Liang
中科院分区：
文献类型：
--
作者：
Wang, Qian-Qian;Cheng, Li;Wu, Bi-Yu;Xu, Ping;Qiu, Hong-Yi;Wang, Bo;Yan, Xiu-Juan;Chen, Sheng-Liang
关键词：
用于治疗肠-脑相互作用疾病（例如难治性功能性消化不良（rFD））的长程（LC）抗抑郁药会使患者面临抗抑郁药停药综合征（ADS）的风险。速效抗抑郁药的短程（SC）治疗可以减少停药综合征，同时保持对消化不良症状的疗效。然而，缺乏基于证据的研究。本研究旨在确定 SC 抗抑郁药治疗是否可以降低 ADS 风险，且治疗效果与 LC 治疗 rFD 相当。这项针对 rFD 患者的随机临床试验是在中国的一家三级医院进行的。参与者 (N = 240) 被随机分配接受氟哌噻吨美利曲辛 (FM) 加奥美拉唑治疗，分别为 2 周（SC 组）或 4 周（LC 组）。利兹消化不良问卷 (LDQ)、广泛性焦虑症 7 (GAD-7) 和抑郁症患者健康问卷 9 (PHQ-9) 的评分在基线时和每 2 周进行一次评估，在治疗后 4 周结束。停药后评估 ADS。计算了 FM 的药物持有率 (MPR)。 SC组患者ADS严重程度和发生率均显着低于LC组（0.60±0.62比1.71±1.58和3.64比39.45%，均P < 0.0001）。 SC组患者的FM MPR值显着高于LC组（P < 0.0001）。两组患者LDQ、GAD-7、PHQ-9评分均下降，且SC组治疗后症状改善与LC组相当。与 4 周 FM 治疗相比，2 周 FM 治疗降低了 rFD 患者发生 ADS 的风险，且治疗效果不较差。临床试验.gov，标识符 NCT05099913。
Long-course (LC) antidepressants for the treatment of disorders of gut-brain interaction, such as refractory functional dyspepsia (rFD), pose patients at risk of antidepressant discontinuation syndrome (ADS). Short-course (SC) therapy of rapid-acting antidepressant may reduce discontinuation syndromes while maintaining efficacy for dyspeptic symptoms. However, the evidence-based research is lacking. This study aims to determine whether SC therapy with antidepressants could decrease the risk of ADS with comparable treatment efficacy to LC therapy in rFD. This randomized clinical trial with rFD patients was conducted at a tertiary hospital in China. Participants (N = 240) were randomly allocated to receive flupentixol-melitracen (FM) plus omeprazole therapy for 2 (SC group) or 4 (LC group) weeks, respectively. Scores for Leeds Dyspepsia Questionnaire (LDQ), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 for Depression (PHQ-9) were assessed at baseline and every 2 weeks, ending at 4 weeks after treatment. ADS was assessed after drug cessation. Medication possession ratio (MPR) for FM was calculated. The severity and incidence of ADS of patients in SC group were significantly lower than those in LC group (0.60 ± 0.62 vs. 1.71 ± 1.58 and 3.64 vs. 39.45%; both P < 0.0001). The MPR values for FM were significantly higher in patients of SC group than in LC group (P < 0.0001). Scores for LDQ, GAD-7 and PHQ-9 decreased in patients of both groups, and the symptom improvement in SC group was comparable to that in LC group after treatment. Compared to 4-week FM therapy, the 2-week FM therapy reduces the risk of ADS with non-inferior treatment efficacy in patients with rFD. Clinical trials.gov, identifier NCT05099913.
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DOI：
10.1177/0269881119845799
发表时间：
2019-06
期刊：
Journal of psychopharmacology (Oxford, England)
影响因子：
--
作者：
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通讯作者：
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影响因子：
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DOI：
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发表时间：
2007-12-01
影响因子：
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