日本为患有重度抑郁症的老年人提供的抗抑郁药:系统回顾和荟萃分析。

IF 2 Q3 NEUROSCIENCES
Neuropsychopharmacology Reports Pub Date : 2024-03-01 Epub Date: 2024-02-06 DOI:10.1002/npr2.12422
Taro Kishi, Kenji Sakuma, Masakazu Hatano, Takenori Okumura, Masaki Kato, Hajime Baba, Nakao Iwata
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引用次数: 0

摘要

目的:为了更新日本情绪障碍协会的重度抑郁障碍(MDD)治疗指南,我们对日本现有的针对患有重度抑郁障碍的老年人的双盲、随机、安慰剂对照试验进行了系统回顾和配对荟萃分析:结果指标包括应答率(主要指标)、抑郁症状量表评分改善率、缓解率、全因停药率、因不良反应停药率以及至少一种不良反应。采用随机效应模型计算风险比(RR)和标准化平均差(SMD)以及95%置信区间(95% CI):结果:共发现九项双盲、随机、安慰剂对照试验(n = 2145)。在日本没有进行任何研究。我们的荟萃分析包括以下抗抑郁药:度洛西汀、艾司西酞普兰、丙咪嗪、舍曲林、文拉法辛和伏硫西汀。抗抑郁药的应答率明显高于安慰剂(RR [95% CI] = 1.38 [1.04, 1.83],P = 0.02)。在改善抑郁症状量表评分方面,抗抑郁药的表现优于安慰剂(SMD [95% CI] = -0.62 [-0.92, -0.33],P 结论:我们的荟萃分析得出结论,日本现有的抗抑郁药治疗中度至重度老年多发性抑郁症的推荐程度较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antidepressants available in Japan for older people with major depressive disorder: A systematic review and meta-analysis.

Aim: To update the major depressive disorder (MDD) treatment guidelines of the Japanese Society of Mood Disorders, we conducted a systematic review and pairwise meta-analysis of double-blind, randomized, placebo-controlled trials of available antidepressants in Japan for older adults with MDD.

Methods: Outcome measures included response rate (primary), improvement in depressive symptom scale score, remission rate, all-cause discontinuation, discontinuation due to adverse events, and at least one adverse event. A random-effects model was used to calculate the risk ratio (RR) and standardized mean difference (SMD) with a 95% confidence interval (95% CI).

Results: Nine double-blind, randomized, placebo-controlled trials (n = 2145) were identified. No study has been conducted in Japan. Our meta-analysis included the following antidepressants: duloxetine, escitalopram, imipramine, sertraline, venlafaxine, and vortioxetine. Antidepressants have significantly higher response rates than placebo (RR [95% CI] = 1.38 [1.04, 1.83], p = 0.02). Antidepressants outperformed placebo in terms of improving depressive symptom scale score (SMD [95% CI] = -0.62 [-0.92, -0.33], p < 0.0001). However, antidepressants were associated with a higher discontinuation rate due to adverse events (RR [95% CI] = 1.94 [1.30, 2.88], p = 0.001) and a higher incidence of at least one adverse event (RR [95% CI] = 1.11 [1.02, 1.21], p = 0.02) compared to placebo. The groups did not differ significantly in terms of remission rate or all-cause discontinuation.

Conclusions: Our meta-analysis concluded that treatment with antidepressants available in Japan is only weakly recommended for moderate to severe MDD in older adults.

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来源期刊
Neuropsychopharmacology Reports
Neuropsychopharmacology Reports Psychology-Clinical Psychology
CiteScore
3.60
自引率
4.00%
发文量
75
审稿时长
14 weeks
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