{"title":"抗抑郁药在早期亨廷顿病中的应用:一项系统回顾和荟萃分析","authors":"Vishnu Tiwari, Sanjukta Dutta, Feras Alkharboush, Mario Renato Velit, Zelde Espinel","doi":"10.1080/17582024.2025.2510145","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>While neuropsychiatric symptoms are common in Huntington's Disease (HD), there is a dearth of evidence about the effectiveness of psychotropic medication for treating behavioral and cognitive symptoms. This article systematically reviews and aggregates the evidence of the effects of antidepressants on individuals with early HD.</p><p><strong>Methods: </strong>A systematic review and random-effects meta-analysis of RCTs comparing antidepressants to placebo in individuals with HD was performed, with a focus on outcomes of executive functioning, functional capacity, mood, motor function, and adverse events.</p><p><strong>Results: </strong>A total of 4 studies with 123 of patients with early HD, of whom a total of 63 (51.2%) received an antidepressant, were identified in our search. In our pooled analysis, a modest but statistically significant improvement in mood resulted from antidepressant treatment in HD (OR -1.22; 95% CI -2.16,-0.27; <i>p</i> = 0.02). No significant differences in the other outcomes of interest were found following antidepressant exposure.</p><p><strong>Conclusions: </strong>Our investigation suggests that antidepressant use may modestly improve mood, but not ameliorate functional, cognitive, or movement-related symptoms in mild HD. Further studies involving novel agents, larger samples, and longer follow-up times are needed to better characterize the effect of antidepressants on neuropsychiatric symptoms in HD.</p>","PeriodicalId":19114,"journal":{"name":"Neurodegenerative disease management","volume":" ","pages":"1-8"},"PeriodicalIF":2.3000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of antidepressants in early Huntington's Disease: a systematic review and meta-analysis.\",\"authors\":\"Vishnu Tiwari, Sanjukta Dutta, Feras Alkharboush, Mario Renato Velit, Zelde Espinel\",\"doi\":\"10.1080/17582024.2025.2510145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>While neuropsychiatric symptoms are common in Huntington's Disease (HD), there is a dearth of evidence about the effectiveness of psychotropic medication for treating behavioral and cognitive symptoms. This article systematically reviews and aggregates the evidence of the effects of antidepressants on individuals with early HD.</p><p><strong>Methods: </strong>A systematic review and random-effects meta-analysis of RCTs comparing antidepressants to placebo in individuals with HD was performed, with a focus on outcomes of executive functioning, functional capacity, mood, motor function, and adverse events.</p><p><strong>Results: </strong>A total of 4 studies with 123 of patients with early HD, of whom a total of 63 (51.2%) received an antidepressant, were identified in our search. In our pooled analysis, a modest but statistically significant improvement in mood resulted from antidepressant treatment in HD (OR -1.22; 95% CI -2.16,-0.27; <i>p</i> = 0.02). No significant differences in the other outcomes of interest were found following antidepressant exposure.</p><p><strong>Conclusions: </strong>Our investigation suggests that antidepressant use may modestly improve mood, but not ameliorate functional, cognitive, or movement-related symptoms in mild HD. Further studies involving novel agents, larger samples, and longer follow-up times are needed to better characterize the effect of antidepressants on neuropsychiatric symptoms in HD.</p>\",\"PeriodicalId\":19114,\"journal\":{\"name\":\"Neurodegenerative disease management\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurodegenerative disease management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/17582024.2025.2510145\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurodegenerative disease management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/17582024.2025.2510145","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:虽然神经精神症状在亨廷顿舞蹈病(HD)中很常见,但关于精神药物治疗行为和认知症状的有效性的证据缺乏。本文系统地回顾和汇总了抗抑郁药对早期HD患者影响的证据。方法:对比较抗抑郁药和安慰剂在HD患者中的随机对照试验进行系统回顾和随机效应荟萃分析,重点关注执行功能、功能容量、情绪、运动功能和不良事件的结果。结果:在我们的研究中,共有4项研究,123例早期HD患者,其中63例(51.2%)接受了抗抑郁药。在我们的汇总分析中,抗抑郁药物治疗对HD患者的情绪有适度但统计学上显著的改善(OR -1.22;95% ci -2.16,-0.27;p = 0.02)。抗抑郁药物暴露后的其他结果没有发现显著差异。结论:我们的研究表明,抗抑郁药的使用可以适度改善轻度HD患者的情绪,但不能改善功能、认知或运动相关症状。为了更好地描述抗抑郁药对HD患者神经精神症状的影响,需要进一步的研究,包括新的药物、更大的样本和更长的随访时间。
Use of antidepressants in early Huntington's Disease: a systematic review and meta-analysis.
Background: While neuropsychiatric symptoms are common in Huntington's Disease (HD), there is a dearth of evidence about the effectiveness of psychotropic medication for treating behavioral and cognitive symptoms. This article systematically reviews and aggregates the evidence of the effects of antidepressants on individuals with early HD.
Methods: A systematic review and random-effects meta-analysis of RCTs comparing antidepressants to placebo in individuals with HD was performed, with a focus on outcomes of executive functioning, functional capacity, mood, motor function, and adverse events.
Results: A total of 4 studies with 123 of patients with early HD, of whom a total of 63 (51.2%) received an antidepressant, were identified in our search. In our pooled analysis, a modest but statistically significant improvement in mood resulted from antidepressant treatment in HD (OR -1.22; 95% CI -2.16,-0.27; p = 0.02). No significant differences in the other outcomes of interest were found following antidepressant exposure.
Conclusions: Our investigation suggests that antidepressant use may modestly improve mood, but not ameliorate functional, cognitive, or movement-related symptoms in mild HD. Further studies involving novel agents, larger samples, and longer follow-up times are needed to better characterize the effect of antidepressants on neuropsychiatric symptoms in HD.