Papakostas George I, Kornstein Susan G, Clayton Anita H, Soares Claudio N, Hallett Lindsay A, Krishen Alok, Tucker Vivian L
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Int Clin Psychopharmacol. 2007 Jul;22(4):226-9. doi: 10.1097/YIC.0b013e32819f8400.
To determine whether age/gender-based differences in efficacy exist between bupropion and the selective serotonin reuptake inhibitors for major depressive disorder, we pooled the findings of 10 double-blind studies comparing bupropion with a selective serotonin reuptake inhibitor. Men (N=943) and women (N=1179) were divided into three age groups (younger than 40, 40-55, older than 55). Improvement in terms of the 17-item Hamilton Depression Rating Scale, as well as the Bech melancholia, anxiety-somatization, and insomnia factors of the Hamilton Depression Rating Scale was compared between the two treatment groups. Of 64 pair-wise comparisons, only one was statistically significant. Specifically, more women treated with a selective serotonin reuptake inhibitor experienced a 50% or greater decrease in Hamilton Depression Rating Scale Anxiety-Somatization scores (58.8 versus 63.8%, P=0.0394). No difference, however, was seen in the degree of resolution of Hamilton Depression Rating Scale Anxiety-Somatization scores (continuous measure) between women treated with bupropion versus a selective serotonin reuptake inhibitor (P=0.114). Bupropion and the selective serotonin reuptake inhibitors, thus, appear to be equally effective in treating depressive symptoms, as well as anxious/somatic symptoms and insomnia in depression. No gender-related or age-related differences were found except that greater improvement was seen in anxious/somatic symptoms of depression among women during selective serotonin reuptake inhibitor treatment. This finding could, however, not be replicated when improvement in anxious/somatic symptoms was defined as a continuous measure.
为了确定安非他酮与选择性5-羟色胺再摄取抑制剂治疗重度抑郁症时疗效是否存在基于年龄/性别的差异，我们汇总了10项比较安非他酮与选择性5-羟色胺再摄取抑制剂的双盲研究结果。男性（N = 943）和女性（N = 1179）被分为三个年龄组（40岁以下、40 - 55岁、55岁以上）。比较了两个治疗组在17项汉密尔顿抑郁量表以及汉密尔顿抑郁量表的贝克忧郁症、焦虑-躯体化和失眠因子方面的改善情况。在64项两两比较中，只有一项具有统计学意义。具体而言，接受选择性5-羟色胺再摄取抑制剂治疗的女性中，有更多人汉密尔顿抑郁量表焦虑-躯体化得分下降了50%或更多（58.8%对63.8%，P = 0.0394）。然而，接受安非他酮治疗与接受选择性5-羟色胺再摄取抑制剂治疗的女性在汉密尔顿抑郁量表焦虑-躯体化得分（连续测量）的缓解程度上没有差异（P = 0.114）。因此，安非他酮和选择性5-羟色胺再摄取抑制剂在治疗抑郁症状以及抑郁症中的焦虑/躯体症状和失眠方面似乎同样有效。除了在选择性5-羟色胺再摄取抑制剂治疗期间女性抑郁症的焦虑/躯体症状有更大改善外，未发现与性别或年龄相关的差异。然而，当将焦虑/躯体症状的改善定义为连续测量时，这一发现无法重复。
