Parker G, Parker K, Austin M P, Mitchell P, Brotchie H
Mood Disorders Unit, Black Dog Institute, Prince of Wales Hospital, Sydney, NSW, Australia.
Psychol Med. 2003 Nov;33(8):1473-7. doi: 10.1017/s0033291703007918.
A recent US study presented data suggesting that depressed women are more likely to respond to selective serotonin reuptake inhibitor (SSRI) than tricyclic (TCA) antidepressant drug therapies. We have undertaken replication studies in two independent databases.
We have examined for gender differences in SSRI and TCA antidepressant response in both retrospective and prospective naturalistic uncontrolled studies, and in subsets of melancholic and non-melancholic depressed subjects. As the US study had indicated that women under the age of 40 years were particularly likely to show a differential response to SSRIs, we examined for age, gender and interactional effects. In addition, we examined for differential SSRI and TCA responsiveness in a subset of patients who had received drugs from both classes.
We failed to find evidence of women having a preferential response to SSRI medication or, conversely, of men having a superior response to TCA medication. Older age, however, was associated with a superior TCA response and younger age with a superior SSRI response.
As few studies have examined for differential gender and age effects in response to narrow action and broad action antidepressant drugs across major depressive subtypes, gender differential effects remain to be established.
美国最近的一项研究提出的数据表明，与三环类抗抑郁药（TCA）疗法相比，抑郁症女性患者对选择性5-羟色胺再摄取抑制剂（SSRI）的反应可能更佳。我们在两个独立数据库中进行了重复研究。
我们在回顾性和前瞻性自然主义非对照研究中，以及在忧郁症和非忧郁症抑郁症患者亚组中，研究了SSRI和TCA抗抑郁反应中的性别差异。由于美国的研究表明，40岁以下的女性对SSRI表现出差异反应的可能性特别大，因此我们研究了年龄、性别及相互作用效应。此外，我们在一部分同时接受过两类药物治疗的患者中，研究了SSRI和TCA反应的差异。
我们未能找到证据证明女性对SSRI药物有优先反应，或者相反，男性对TCA药物有更好的反应。然而，年龄较大与TCA反应较好相关，年龄较小与SSRI反应较好相关。
由于很少有研究在主要抑郁亚型中研究对作用机制较窄和较宽的抗抑郁药物反应的性别差异和年龄差异，性别差异效应仍有待确定。
