Meta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder.
Meta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder.
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DOI：
10.1038/mp.2009.50
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发表时间：
2010-08
影响因子：
11
通讯作者：
中科院分区：
文献类型：
--
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我们试图通过荟萃分析确定不同剂量选择性血清素再摄取抑制剂治疗强迫症（OCD）的疗效和耐受性的差异。我们确定了9项涉及2268名受试者的随机双盲安慰剂对照临床试验，比较了多种固定剂量的选择性血清素再摄取抑制剂（SSRIs）和安慰剂在治疗成人强迫症中的作用。对每项纳入研究的Y-BOCS评分的变化、治疗反应的比例和退出（全因和由于副作用）进行了测定。采用加权均差法检测Y-BOCS评分的平均变化。合并绝对风险差用于检查二分类结果。meta分析采用RevMan 4.2.8软件中的固定效应模型。我们发现，与低剂量或中剂量相比，使用Y-BOCS评分或治疗应答者比例作为结果，高剂量的SSRIs与改善的治疗效果相关。SSRIs的剂量与全因退出的数量无关。高剂量的SSRIs与高比例的因副作用而退出相关。这些结果表明，高剂量的SSRIs与治疗强迫症的更有效相关。这种SSRI的疗效模式与其他精神疾病如重度抑郁症形成对比。这种更大的治疗效果在一定程度上被更高剂量的SSRIs带来的更大的副作用负担所抵消。目前，没有足够的数据将这些发现推广到患有强迫症的儿童或青少年。
We sought to determine differences in efficacy and tolerability between different doses of selective serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder (OCD) using meta-analysis.. We identified 9 studies involving 2268 subjects that were randomized, double-blind placebo-controlled clinical trials that compared multiple, fixed-doses of selective serotonin reuptake inhibitors (SSRIs) to each other and to placebo in the treatment of adults with OCD. Change in Y-BOCS score, proportion of treatment responders, and dropouts (all-cause and due to side-effects) were determined for each included study. Weighted mean difference was used to examine mean change in Y-BOCS score. Pooled absolute risk difference was used to examine dichotomous outcomes. Meta-analysis was performed using a fixed effects model in RevMan 4.2.8. We found that compared with either low or medium doses, higher doses of SSRIs were associated with improved treatment efficacy, using either Y-BOCS score or proportion of treatment responders as an outcome. Dose of SSRIs was not associated with the number of all-cause dropouts. Higher doses of SSRIs were associated with significantly higher proportion of dropouts due to side-effects. These results suggests that higher doses of SSRIs are associated with greater efficacy in the treatment of OCD. This SSRI efficacy pattern stands in contrast to other psychiatric disorders like Major Depressive Disorder. This greater treatment efficacy is somewhat counterbalanced by the greater side-effect burden with higher doses of SSRIs. At present, there are insufficient data to generalize these findings to children or adolescents with OCD.
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影响因子：
5.3
作者：
Ninan, PT;Koran, LM;Austin, C
通讯作者：
Austin, C
影响因子：
5.3
作者：
Hollander, E;Allen, A;Burnham, DB
通讯作者：
Burnham, DB
影响因子：
10.5
作者：
Bebbington, PE
通讯作者：
Bebbington, PE
DOI：
10.1017/s1461145702002900
发表时间：
2002-06-01
影响因子：
4.8
作者：
Pallanti, S;Hollander, E;Zohar, J
通讯作者：
Zohar, J
DOI：
10.1016/0924-977x(93)90266-o
发表时间：
1993-06-01
期刊：
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
影响因子：
--
作者：
Montgomery, S A;McIntyre, A;Wood, A J
通讯作者：
Wood, A J