Leon A C, Blier P, Culpepper L, Gorman J M, Hirschfeld R M, Nierenberg A A, Roose S P, Rosenbaum J F, Stahl S M, Trivedi M H
Department of Biostatistics in Psychiatry, Weill Medical College of Cornell University, New York, NY 10021, USA.
J Clin Psychiatry. 2001;62 Suppl 4:34-6; discussion 37-40.
Although various published clinical studies have suggested that some antidepressants may have a more rapid onset of therapeutic effect than others, none of these trials was adequately designed to measure differential time to onset of effect. Thus, existing data do not support claims that one drug reduces the symptoms of depression faster than another. In this article, we propose a study that would be ideal for measuring comparative onset of antidepressant effect. The key features of this ideal trial include (1) a prospective definition of early onset of action, (2) increased frequency of assessment, (3) a data-analytic approach capable of capturing the dynamic nature of symptomatic change, and (4) various strategies to minimize bias and heterogeneity of response.
尽管各种已发表的临床研究表明，某些抗抑郁药可能比其他药物具有更快的治疗效果起效时间，但这些试验均未进行充分设计以测量不同药物的起效时间差异。因此，现有数据并不支持一种药物比另一种药物能更快减轻抑郁症状的说法。在本文中，我们提出一项研究，该研究将是测量抗抑郁药效果比较起效时间的理想选择。这项理想试验的关键特征包括：（1）对早期起效的前瞻性定义；（2）增加评估频率；（3）一种能够捕捉症状变化动态性质的数据分析方法；以及（4）各种将反应偏差和异质性降至最低的策略。
