Onset of action of antidepressants: results of different analyses
Onset of action of antidepressants: results of different analyses
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DOI：
10.1002/hup.386
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发表时间：
2002-06
期刊：
影响因子：
--
通讯作者：
C. Thompson
中科院分区：
文献类型：
--
作者：
C. Thompson
由于抗抑郁药的价值因其起效延迟而受到阻碍，因此相当多的注意力集中在开发一种起效更快的药物上。然而，尽管目前正在进行具体研究，但迄今为止，文献中尚未发表经过同行评审的前瞻性行动试验。目前可以从事后汇总分析中获得一些数据，并且已经开发了多种方法来评估行动的开始；其中包括反应时间、治疗效果起效时间、模式分析和生存分析。对四项大规模双盲研究的分析为米氮平比 SSRIs（氟西汀、帕罗西汀和西酞普兰）更早起效提供了证据。治疗 1 周后，米氮平和 SSRI 之间出现显着差异。这种效果在四种不同的方法中是一致的，并且似乎是由于特定的抗抑郁作用而不是对睡眠等的早期影响。这些发现有待专门设计的前瞻性行动研究的证实。版权所有 © 2002 约翰威利父子有限公司
Because the value of antidepressants is hampered by their delay in onset of action, considerable attention has been focused on developing a drug that acts more rapidly. However, although specific studies are now ongoing, there have been no peer‐reviewed prospective onset of action trials published in the literature to date. Some data are currently available from post‐hoc pooled analyses and numerous methods have been developed for evaluating the onset of action; these include the time to response, the time to onset of therapeutic effect, pattern analysis and survival analyses. Such an analysis of four large‐scale, double‐blind studies has provided evidence for an earlier onset of action with mirtazapine than with the SSRIs (fluoxetine, paroxetine and citalopram). Significant differences were seen between mirtazapine and the SSRIs after 1 week of treatment. This effect was consistent across the four different methodologies and appears to be due to a specific antidepressant effect rather than an early effect on, for example, sleep. These findings await confirmation from specifically designed prospective onset of action studies. Copyright © 2002 John Wiley & Sons, Ltd.