A Metaanalysis of Controlled Trials of Neuroleptic Treatment in Dementia
A Metaanalysis of Controlled Trials of Neuroleptic Treatment in Dementia
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抗痴呆药物治疗对照试验的荟萃分析
DOI：
10.1111/j.1532-5415.1990.tb02407.x
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发表时间：
1990
影响因子：
6.3
通讯作者：
S. Lyness
中科院分区：
文献类型：
--
作者：
L. Schneider;V. Pollock;S. Lyness
先前关于在痴呆中使用抗精神病药的定性文献综述表明，它们在治疗躁动方面“适度有效”，并且没有一种抗精神病药比另一种更好。为了更准确地了解抗精神病药物的临床疗效，我们对现有文献进行了荟萃分析。双盲临床试验比较了一种抗精神病药和一种安慰剂对躁动性痴呆患者的治疗效果，获得了P值和效应大小估计，并通过荟萃分析技术进行了评估。结果显示，抗精神病药明显比安慰剂更有效（单尾P = 0.004），且效应量较小（r = 0.18）。临床上，抗精神病药物治疗可改变躁动性痴呆患者的治愈率。41 . to…59（二项效应-尺寸显示）。这表明100名痴呆患者中有18名受益于抗精神病药物治疗（超过安慰剂），并且与先前定性评价中描述的适度疗效一致。在比较硫硝嗪与另一种抗精神病药物的6项研究和比较氟哌啶醇与另一种抗精神病药物的5项研究中，荟萃分析结果未显示这两种药物与比较药物有显著差异，这与没有一种抗精神病药物优于另一种的观点并不矛盾。
Prior qualitative literature reviews about the use of neuroleptics in dementia suggest that they are “modestly effective” in treating agitation and that no single neuroleptic is better than another. To develop a more precise concept of the clinical efficacy of neuroleptics, a meta‐analytic review of the existing literature was performed. From double‐blind clinical trials that compared a neuroleptic with a placebo in agitated dementia patients, P values and effect‐size estimates were obtained, and were assessed by metaanalytic techniques. Results indicated that neuroleptics were significantly more effective than placebo (one‐tailed P = .004) and had a small effect size (r = .18). Clinically, neuroleptic treatment changed the improvement rate in agitated dementia patients from .41 to .59 (binomial effect‐size display). This indicates that 18 of 100 dementia patients benefited from neuroleptic treatment (beyond that of placebo) and is consistent with the modest efficacy described in previous qualitative reviews. In six studies comparing thioridazine with another neuroleptic, and in five studies comparing haloperidol with another neuroleptic, metaanalysis results did not show that these two medications differed significantly from the comparison medications, which is not inconsistent with the opinion that no single neuroleptic is better than another.
精神病、行为障碍以及精神安定药在痴呆症中的使用。
影响因子：
7.3
作者：
Devanand,DP;Sackeim,HA;Mayeux,R
通讯作者：
Mayeux,R