Efficacy and tolerability of antidepressants monotherapy for behavioral and psychological symptoms of dementia: A meta-analysis of randomized controlled trials

IF 3.7 2区 医学 Q1 PSYCHIATRY
Meng Dong , Chang Liu , Haiyan Luo , Dongyun Su , Gongbo Li , Fenghua Xu , Min Song , Yuqing Zhang
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引用次数: 0

Abstract

Behavioral and psychological symptoms of dementia (BPSD) are common and difficult to manage. Although experimental data suggest that antidepressants may reduce BPSD, the results are inconclusive. To evaluate the efficacy and tolerability of antidepressants monotherapy for treating BPSD. We searched 10 cross-disciplinary electronic databases from inception to October 2023.Randomized controlled trials (RCTs) comparing antidepressants versus placebo for treating BPSD were included. The primary outcome was change in total neuropsychiatric symptom scale scores. Secondary outcomes included changes on agitation and psychosis subscale scores, change in total score of Mini-mental State Examination (MMSE). Tolerability outcomes included incidences and discontinuations due to adverse events. Finally, 8 RCTs including 676 patients were identified. We found a small beneficial effect of antidepressants on overall BPSD However, when trials with potential high-dose citalopram were excluded, no improvement was observed. No significant effects were detected on agitation and cognition. Currently there is no clear evidence of a beneficial effect of currently available antidepressants on overall BPSD and in particular agitation. Notably, clinician should be cautious of the potential risk of arrhythmias, dizziness and diarrhea when prescribing an antidepressant.
抗抑郁药单药治疗痴呆行为和心理症状的疗效和耐受性:随机对照试验的荟萃分析
痴呆症的行为和心理症状(BPSD)是常见的和难以管理。虽然实验数据表明抗抑郁药可以减少BPSD,但结果还不确定。评价抗抑郁药单药治疗BPSD的疗效和耐受性。我们检索了从成立到2023年10月的10个跨学科电子数据库。包括比较抗抑郁药与安慰剂治疗BPSD的随机对照试验(rct)。主要结局是神经精神症状量表总分的改变。次要结果包括躁动和精神病亚量表得分的变化,迷你精神状态检查(MMSE)总分的变化。耐受性结局包括发生率和不良事件引起的停药。最终纳入8项rct,共纳入676例患者。我们发现抗抑郁药对整体BPSD有小的有益作用,然而,当排除潜在的大剂量西酞普兰的试验时,没有观察到改善。在躁动和认知方面没有发现明显的影响。目前还没有明确的证据表明,目前可用的抗抑郁药物对整体BPSD,特别是躁动有有益的影响。值得注意的是,临床医生在开抗抑郁药时应小心潜在的心律失常、头晕和腹泻风险。
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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