Mackay F R, Dunn N R, Martin R M, Pearce G L, Freemantle S N, Mann R D
Br J Gen Pract. 1999 Nov;49(448):892-6.
An increasing number of antidepressants have been released on the United Kingdom market in recent years, and these are being prescribed more frequently in general practice. Clinical trials suggest that such agents have similar efficacy and the choice of drug is probably based on tolerability, toxicity in overdose, and cost.
To compare the tolerability and safety profile of six, newly marketed antidepressants used in general practice.
Studies have been conducted for six antidepressants: fluoxetine, sertraline, paroxetine, moclobemide, venlafaxine, and nefazodone, using the technique of prescription-event monitoring. Patients were identified using incident dispensed prescription data. Questionnaires were sent to patients' general practitioners six months after the date of first prescription. Questionnaires asked for date of birth, sex, indication for prescribing each drug, and all events entered in the patients' records after the date of first prescription.
Each cohort exceeded 10,000 patients. Nausea/vomiting was the most frequently reported event for all drugs. The difference in incidence rates for drowsiness/sedation, male sexual dysfunction, and hypertension is shown. Mortality data are also reported.
Frequently reported events were similar for all six drugs but there were clinically and statistically significant differences for less frequently reported events. The adjusted mortality rate was identical between the six drugs. This study provides valuable comparative data for six, widely used antidepressants in general practice.
近年来，越来越多的抗抑郁药投放至英国市场，并且在全科医疗中这些药物的处方开具频率越来越高。临床试验表明，此类药物具有相似的疗效，药物选择可能基于耐受性、过量用药时的毒性以及成本。
比较六种全科医疗中常用的新上市抗抑郁药的耐受性和安全性。
采用处方事件监测技术对六种抗抑郁药进行了研究：氟西汀、舍曲林、帕罗西汀、吗氯贝胺、文拉法辛和奈法唑酮。利用首次配药的处方数据识别患者。在首次处方日期六个月后向患者的全科医生发送问卷。问卷询问出生日期、性别、每种药物的处方开具指征以及首次处方日期之后患者记录中录入的所有事件。
每个队列的患者均超过10,000例。恶心/呕吐是所有药物报告最频繁的事件。显示了嗜睡/镇静、男性性功能障碍和高血压的发生率差异。还报告了死亡率数据。
所有六种药物报告频繁的事件相似，但报告较少的事件在临床和统计学上存在显著差异。六种药物的调整死亡率相同。本研究为全科医疗中广泛使用的六种抗抑郁药提供了有价值的比较数据。
