{"title":"电惊厥联合抗抑郁药物治疗难治性抑郁症的临床疗效:荟萃分析。","authors":"Xiaoli Sun, Junyun Liu, Wanwen Li","doi":"10.1177/00912174251338962","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveTo systematically evaluate the efficacy of electroconvulsive therapy (ECT) combined with antidepressant medication in patients with treatment-resistant depression.MethodsA search of the CNKI, Wanfang, Vip, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science databases was conducted from their inception to January 1, 2025. Randomized controlled trials evaluating the efficacy of ECT combined with antidepressant medication in patients with treatment-resistant depression were included. The experimental group received ECT combined with antidepressant drugs, while the control group received either ECT alone or ECT combined with a placebo. Data were analyzed using RevMan 5.2 software.ResultsA total of 11 randomized controlled trials involving 1254 patients were included in the analysis. Patients treated with ECT combined with antidepressants showed significantly greater improvement in depressive symptoms (<i>SMD</i> = -0.29, <i>95% CI</i> = -0.47 to -0.12, <i>P</i> = 0.001) and higher remission rates (<i>OR</i> = 1.73, <i>95% CI</i> = 1.24 to 2.40, <i>P</i> = 0. 001) compared to patients treated with ECT alone. There was no significant difference between the two groups in seizure duration (<i>SMD</i> = 0.17, <i>95% CI</i> = -0.14 to 0.49, <i>P</i> = 0.28) or the incidence of adverse effects (<i>OR</i> = 1.15, <i>95% CI</i> = 0.73 to 21.82, <i>P</i> = 0.54).ConclusionThe combination of ECT and antidepressant medication modestly improves depressive symptoms and increases remission rates in patients with treatment-resistant depression. Additionally, it shows no significant difference in seizure duration or the incidence of adverse reactions compared to ECT alone, suggesting its comparable safety profile.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":" ","pages":"912174251338962"},"PeriodicalIF":1.3000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical efficacy of electroconvulsive therapy combined with antidepressant medication in patients with treatment-resistant depression: A meta-analysis.\",\"authors\":\"Xiaoli Sun, Junyun Liu, Wanwen Li\",\"doi\":\"10.1177/00912174251338962\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>ObjectiveTo systematically evaluate the efficacy of electroconvulsive therapy (ECT) combined with antidepressant medication in patients with treatment-resistant depression.MethodsA search of the CNKI, Wanfang, Vip, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science databases was conducted from their inception to January 1, 2025. Randomized controlled trials evaluating the efficacy of ECT combined with antidepressant medication in patients with treatment-resistant depression were included. The experimental group received ECT combined with antidepressant drugs, while the control group received either ECT alone or ECT combined with a placebo. Data were analyzed using RevMan 5.2 software.ResultsA total of 11 randomized controlled trials involving 1254 patients were included in the analysis. Patients treated with ECT combined with antidepressants showed significantly greater improvement in depressive symptoms (<i>SMD</i> = -0.29, <i>95% CI</i> = -0.47 to -0.12, <i>P</i> = 0.001) and higher remission rates (<i>OR</i> = 1.73, <i>95% CI</i> = 1.24 to 2.40, <i>P</i> = 0. 001) compared to patients treated with ECT alone. There was no significant difference between the two groups in seizure duration (<i>SMD</i> = 0.17, <i>95% CI</i> = -0.14 to 0.49, <i>P</i> = 0.28) or the incidence of adverse effects (<i>OR</i> = 1.15, <i>95% CI</i> = 0.73 to 21.82, <i>P</i> = 0.54).ConclusionThe combination of ECT and antidepressant medication modestly improves depressive symptoms and increases remission rates in patients with treatment-resistant depression. Additionally, it shows no significant difference in seizure duration or the incidence of adverse reactions compared to ECT alone, suggesting its comparable safety profile.</p>\",\"PeriodicalId\":50294,\"journal\":{\"name\":\"International Journal of Psychiatry in Medicine\",\"volume\":\" \",\"pages\":\"912174251338962\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-04-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Psychiatry in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00912174251338962\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Psychiatry in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00912174251338962","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
目的系统评价电休克联合抗抑郁药物治疗难治性抑郁症的疗效。方法检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane图书馆、Embase、Web of Science等数据库,检索时间为数据库成立至2025年1月1日。随机对照试验评估电痉挛疗法联合抗抑郁药物治疗难治性抑郁症的疗效。实验组接受电痉挛疗法联合抗抑郁药物治疗,而对照组接受单独电痉挛疗法或电痉挛疗法联合安慰剂治疗。数据分析采用RevMan 5.2软件。结果共纳入11项随机对照试验1254例患者。ECT联合抗抑郁药物治疗的患者抑郁症状明显改善(SMD = -0.29, 95% CI = -0.47 ~ -0.12, P = 0.001),缓解率显著提高(OR = 1.73, 95% CI = 1.24 ~ 2.40, P = 0)。001)与单独接受ECT治疗的患者相比。两组癫痫发作时间(SMD = 0.17, 95% CI = -0.14 ~ 0.49, P = 0.28)和不良反应发生率(or = 1.15, 95% CI = 0.73 ~ 21.82, P = 0.54)差异无统计学意义。结论电痉挛疗法联合抗抑郁药物可适度改善难治性抑郁症患者的抑郁症状,提高缓解率。此外,与单独ECT相比,它在癫痫发作时间或不良反应发生率方面没有显着差异,表明其安全性相当。
Clinical efficacy of electroconvulsive therapy combined with antidepressant medication in patients with treatment-resistant depression: A meta-analysis.
ObjectiveTo systematically evaluate the efficacy of electroconvulsive therapy (ECT) combined with antidepressant medication in patients with treatment-resistant depression.MethodsA search of the CNKI, Wanfang, Vip, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science databases was conducted from their inception to January 1, 2025. Randomized controlled trials evaluating the efficacy of ECT combined with antidepressant medication in patients with treatment-resistant depression were included. The experimental group received ECT combined with antidepressant drugs, while the control group received either ECT alone or ECT combined with a placebo. Data were analyzed using RevMan 5.2 software.ResultsA total of 11 randomized controlled trials involving 1254 patients were included in the analysis. Patients treated with ECT combined with antidepressants showed significantly greater improvement in depressive symptoms (SMD = -0.29, 95% CI = -0.47 to -0.12, P = 0.001) and higher remission rates (OR = 1.73, 95% CI = 1.24 to 2.40, P = 0. 001) compared to patients treated with ECT alone. There was no significant difference between the two groups in seizure duration (SMD = 0.17, 95% CI = -0.14 to 0.49, P = 0.28) or the incidence of adverse effects (OR = 1.15, 95% CI = 0.73 to 21.82, P = 0.54).ConclusionThe combination of ECT and antidepressant medication modestly improves depressive symptoms and increases remission rates in patients with treatment-resistant depression. Additionally, it shows no significant difference in seizure duration or the incidence of adverse reactions compared to ECT alone, suggesting its comparable safety profile.
期刊介绍:
The International Journal of Psychiatry in Medicine (IJPM) bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious, and cultural factors in the development and treatment of illness; the relationship of biomarkers to psychiatric symptoms and syndromes in primary care...