{"title":"创伤后应激障碍的药物治疗：系统回顾和荟萃分析。","authors":"Yanyan Jia, Zifeng Ye, Fude Yang, Jiabao Chai, Haiting Xu, Jingming Yang, Weiye Liang, Lili Wu","doi":"10.1177/20451253251342628","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic stress disorder (PTSD) is a prevalent mental illness with a high disability rate. The neurobiological abnormalities in PTSD suggest that drug therapy may have certain therapeutic effects. According to the recommendations of clinical guidelines for PTSD, the current clinical preference is for selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Nevertheless, the efficacy of other types of drugs remains uncertain, which impacts the selection of personalized treatment for patients.</p><p><strong>Objectives: </strong>The aim of this meta-analysis was to assess the efficacy and acceptability of drugs with different pharmacological mechanisms in alleviating PTSD symptoms by comparing the response rates and dropout rates of different drug treatment groups in randomized clinical trials.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched and analyzed 52 reports that described the efficacy and acceptability of medication for PTSD. Among these, 49 trials used the dropout rate as an acceptability indicator, and 52 trials used the response rate as an efficacy indicator.</p><p><strong>Results: </strong>In the 49 trials with the dropout rate as the indicator, the dropout rate was 29% (95% confidence interval, 0.26-0.33; <i>n</i> = 3870). In the 52 trials with the response rate as the indicator, the response rate was 39% (95% confidence interval, 0.33-0.45; <i>n</i> = 3808). After drug treatment, the core symptoms of PTSD were significantly improved. This meta-analysis indicated that there was no significant difference between antidepressants and antipsychotics in improving clinical symptoms and acceptability. However, antidepressants may have a slight advantage in efficacy, although with a higher dropout rate.</p><p><strong>Conclusion: </strong>Drug treatment is an effective rehabilitation method for PTSD patients, and individualized drug management should be considered.</p><p><strong>Trial registration: </strong>This systematic evaluation scheme has been registered with PROSPERO (protocol ID: CRD42023462662).</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251342628"},"PeriodicalIF":4.0000,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171264/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis.\",\"authors\":\"Yanyan Jia, Zifeng Ye, Fude Yang, Jiabao Chai, Haiting Xu, Jingming Yang, Weiye Liang, Lili Wu\",\"doi\":\"10.1177/20451253251342628\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Post-traumatic stress disorder (PTSD) is a prevalent mental illness with a high disability rate. The neurobiological abnormalities in PTSD suggest that drug therapy may have certain therapeutic effects. According to the recommendations of clinical guidelines for PTSD, the current clinical preference is for selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Nevertheless, the efficacy of other types of drugs remains uncertain, which impacts the selection of personalized treatment for patients.</p><p><strong>Objectives: </strong>The aim of this meta-analysis was to assess the efficacy and acceptability of drugs with different pharmacological mechanisms in alleviating PTSD symptoms by comparing the response rates and dropout rates of different drug treatment groups in randomized clinical trials.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched and analyzed 52 reports that described the efficacy and acceptability of medication for PTSD. Among these, 49 trials used the dropout rate as an acceptability indicator, and 52 trials used the response rate as an efficacy indicator.</p><p><strong>Results: </strong>In the 49 trials with the dropout rate as the indicator, the dropout rate was 29% (95% confidence interval, 0.26-0.33; <i>n</i> = 3870). In the 52 trials with the response rate as the indicator, the response rate was 39% (95% confidence interval, 0.33-0.45; <i>n</i> = 3808). After drug treatment, the core symptoms of PTSD were significantly improved. This meta-analysis indicated that there was no significant difference between antidepressants and antipsychotics in improving clinical symptoms and acceptability. However, antidepressants may have a slight advantage in efficacy, although with a higher dropout rate.</p><p><strong>Conclusion: </strong>Drug treatment is an effective rehabilitation method for PTSD patients, and individualized drug management should be considered.</p><p><strong>Trial registration: </strong>This systematic evaluation scheme has been registered with PROSPERO (protocol ID: CRD42023462662).</p>\",\"PeriodicalId\":23127,\"journal\":{\"name\":\"Therapeutic Advances in Psychopharmacology\",\"volume\":\"15 \",\"pages\":\"20451253251342628\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-06-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171264/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Psychopharmacology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/20451253251342628\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Psychopharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20451253251342628","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis.
Background: Post-traumatic stress disorder (PTSD) is a prevalent mental illness with a high disability rate. The neurobiological abnormalities in PTSD suggest that drug therapy may have certain therapeutic effects. According to the recommendations of clinical guidelines for PTSD, the current clinical preference is for selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Nevertheless, the efficacy of other types of drugs remains uncertain, which impacts the selection of personalized treatment for patients.
Objectives: The aim of this meta-analysis was to assess the efficacy and acceptability of drugs with different pharmacological mechanisms in alleviating PTSD symptoms by comparing the response rates and dropout rates of different drug treatment groups in randomized clinical trials.
Design: Systematic review and meta-analysis.
Methods: We searched and analyzed 52 reports that described the efficacy and acceptability of medication for PTSD. Among these, 49 trials used the dropout rate as an acceptability indicator, and 52 trials used the response rate as an efficacy indicator.
Results: In the 49 trials with the dropout rate as the indicator, the dropout rate was 29% (95% confidence interval, 0.26-0.33; n = 3870). In the 52 trials with the response rate as the indicator, the response rate was 39% (95% confidence interval, 0.33-0.45; n = 3808). After drug treatment, the core symptoms of PTSD were significantly improved. This meta-analysis indicated that there was no significant difference between antidepressants and antipsychotics in improving clinical symptoms and acceptability. However, antidepressants may have a slight advantage in efficacy, although with a higher dropout rate.
Conclusion: Drug treatment is an effective rehabilitation method for PTSD patients, and individualized drug management should be considered.
Trial registration: This systematic evaluation scheme has been registered with PROSPERO (protocol ID: CRD42023462662).
期刊介绍：
Therapeutic Advances in Psychopharmacology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of psychopharmacology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in psychopharmacology, providing a forum in print and online for publishing the highest quality articles in this area.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
