Paroxetine response and tolerability among ethnic minority patients with mood or anxiety disorders: A pooled analysis
Paroxetine response and tolerability among ethnic minority patients with mood or anxiety disorders: A pooled analysis
复制标题
DOI：
10.4088/jcp.v66n1004
复制
发表时间：
2005-10-01
影响因子：
5.3
通讯作者：
Christi, JA
中科院分区：
文献类型：
--
作者：
Roy-Byrne, PP;Perera, P;Christi, JA
背景：由于少数群体接受的心理保健质量较差，记录少数群体和多数群体大样本中焦虑和抑郁药物的相似反应和耐受性的分析可能会提高少数群体中提供者和患者使用药物的意愿。方法：对参与 104 项双盲安慰剂对照帕罗西汀临床试验的 14,875 名成年人进行汇总分析，调查重度抑郁症、恐慌症、广泛性焦虑症、社交焦虑症、从1984年3月到2002年3月的强迫症、创伤后应激障碍或经前烦躁障碍。最后一次观察的意向治疗分析使用临床总体印象（CGI）量表来测量二分结果，分为缓解（CGI评分为1或2）或更完全缓解（CGI评分为1）（“完全缓解”）。使用逻辑回归对整个样本检查少数群体的差异，并对重度抑郁症患者重复进行分析。不良事件发生率超过 5%，是安慰剂的两倍，并以描述性方式列出。最后，生存分析检查了反应开始速度的群体差异。结果：西班牙裔和亚洲受试者的反应率略低，而亚洲人的“完全反应”率最高，西班牙裔的“完全反应”率最低。西班牙裔结果差异更一致似乎是由于安慰剂反应率更高。没有通过少数群体互动来治疗抑郁症患者。各组的反应速度和不良反应相似。结论：药物反应和耐受性几乎没有一致的差异。这些发现可能有助于抵消少数群体中对药物使用较高的负面态度，并增强用于治疗少数群体焦虑和抑郁的药物的价值。
Background: Because of the poor quality of mental health care received by minorities, analyses documenting comparable response to and tolerability of medications for anxiety and depression in large samples of minority and majority populations could increase the willingness of providers and patients to use medications in minority populations.Method: A pooled analysis of 14,875 adults who participated in 104 double-blind placebo, controlled paroxetine clinical trials investigating major depression, panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, or premenstrual dysphoric disorder from March 1984 through March 2002. An intent-to-treat analysis with last observation carried forward used the Clinical Global Impressions (CGI) scale to measure dichotomous outcome, classified as either response (CGI score of 1 or 2) or more complete response (CGI score of 1) ("full response"). Minority group differences were examined using logistic regression for the entire sample and repeated for those with major depression. Adverse events greater than 5% and twice the rate of placebo were descriptively tabulated. Finally, a survival analysis examined group differences in speed of onset of response.Results: Hispanic and Asian subjects had a slightly lower response rate, while Asians had the highest rates and Hispanics had the lowest rates of "full response." The more consistent Hispanic outcome differences appeared to be due to a higher placebo response rate. There was no treatment by minority group interaction for depressed patients. Speed of response and adverse effects were similar across groups.Conclusions: There were few consistent differences in medication response and tolerability. These findings may serve to counteract the greater rate of negative attitudes toward medication use among minorities and reinforce the value of medications used to treat anxiety and depression in minorities.