Krebs Erin E, Gaynes Bradley N, Gartlehner Gerald, Hansen Richard A, Thieda Patricia, Morgan Laura C, DeVeaugh-Geiss Angela, Lohr Kathleen N
Center on Implementing Evidence-Based Practice, Roudebush Veterans Affairs Medical Center, Indianapolis, IN 46202, USA.
Psychosomatics. 2008 May-Jun;49(3):191-8. doi: 10.1176/appi.psy.49.3.191.
Approximately two-thirds of patients with depression experience physical pain symptoms. Coexisting pain complicates the treatment of depression and is associated with worse depression outcomes.
The authors reviewed the effect of newer antidepressants on pain in patients with depression.
The authors searched systematically for trials of second-generation antidepressants that enrolled depression patients and reported pain outcomes, pooling changes on the pain visual-analog scale (VAS), using random-effects models.
Eight trials were eligible. Pooled analysis of head-to-head trials showed no difference in VAS between duloxetine and paroxetine. Both drugs were superior to placebo.
The authors found insufficient evidence to support the choice of one second-generation antidepressant over another in patients with pain accompanying depression.
约三分之二的抑郁症患者会出现身体疼痛症状。并存的疼痛使抑郁症的治疗变得复杂，且与更差的抑郁结局相关。
作者回顾了新型抗抑郁药对抑郁症患者疼痛的影响。
作者系统检索了纳入抑郁症患者并报告疼痛结局的第二代抗抑郁药试验，采用随机效应模型汇总疼痛视觉模拟量表（VAS）的变化。
八项试验符合要求。头对头试验的汇总分析显示，度洛西汀和帕罗西汀在VAS上无差异。两种药物均优于安慰剂。
作者发现，在伴有疼痛的抑郁症患者中，没有足够的证据支持选择一种第二代抗抑郁药而非另一种。
