Pindolol augmentation of serotonin reuptake inhibitors for the treatment of depressive disorder: a systematic review
Pindolol augmentation of serotonin reuptake inhibitors for the treatment of depressive disorder: a systematic review
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吲哚洛尔增强血清素再摄取抑制剂治疗抑郁症：系统评价
DOI：
10.1177/0269881108097714
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发表时间：
2010
影响因子：
4.1
通讯作者：
J. Geddes
中科院分区：
文献类型：
--
作者：
R. Whale;T. Terao;P. Cowen;N. Freemantle;J. Geddes
在5 -羟色胺类抗抑郁药物治疗中加入品多洛尔，提供了一种产生更快起效和增强抗抑郁效果的潜在策略。本综述调查了品多洛尔是否能在连续时间点上提高成人抑郁症患者血清素能抗抑郁药治疗的疗效，最长可达6周。检索策略：Cochrane协作网抑郁、焦虑和神经症对照试验注册和未发表的试验数据。研究选择：随机试验包括抑郁症患者，比较血清素能抗抑郁药+品多洛尔与血清素能抗抑郁药+安慰剂，并使用抑郁症状临床结果量表。数据提取：在>定义的6周时间点的临床反应，尽可能提取每个试验的抑郁量表评分减少50%。确定了11项研究，包括未发表的数据。在1 ~ 6周时间点，治疗的二分类反应的合并优势比为2.39 （95% CI 1.40 ~ 4.06）、2.39（1.74 ~ 3.29）、1.94（1.46 ~ 2.58）、1.59（1.16 ~ 2.18）、1.42（0.87 ~ 2.31）和1.28（0.91 ~ 1.81）。时间到事件分析显示，与安慰剂相比，pindolol增强组的反应更大（P = 0.04）。在某些时间点，研究之间存在显著的异质性。治疗组之间的辍学率没有显著差异。这一综述表明，pindolol增强的总体有益的临床效果，最明显的是长达4周的治疗。
Adding pindolol to serotonergic antidepressant treatment offers a potential strategy for producing a more rapid onset of action and an enhanced antidepressant effect. This review investigated whether pindolol enhances the efficacy of serotonergic antidepressant treatment in adult patients with depressive disorders at sequential time points up to 6 weeks. Search strategy: Cochrane Collaboration Depression, Anxiety and Neurosis-Controlled Trials Register plus unpublished trial data. Study selection: Randomised trials including depressed patients, comparing serotonergic antidepressants + pindolol with serotonergic antidepressants + placebo and using depressive symptom clinical outcomes scales. Data extraction: Clinical response at time points up to 6 weeks as defined by >50% depression scale score reduction was extracted for each trial as possible. Eleven studies were identified including unpublished data. The pooled odds ratios for dichotomous response to treatment at time points from 1 to 6 weeks were 2.39 (95% CI 1.40—4.06), 2.39 (1.74—3.29), 1.94 (1.46—2.58), 1.59 (1.16—2.18), 1.42 (0.87—2.31) and 1.28 (0.91—1.81). Time-to-event analysis showed a greater response with pindolol augmentation versus placebo (P = 0.04). There was significant heterogeneity between studies at some time points. Dropout rates did not significantly differ between treatment arms. This review suggests an overall beneficial clinical effect of pindolol augmentation, most clearly up to 4 weeks of treatment.