Saarinen Jaakko, Kivelä Sirkka-Liisa, Räihä Ismo
Duodecim. 2010;126(21):2503-9.
The aim was to provide a systematic review of the effects of antidepressive drugs on depression among the aged with memory disturbances or dementia. Randomized, controlled trials (RCT) published in 1980-2009 were searched in Medline (PubMed) and Cochrane databases. The material consisted of 11 original RCT's. Depressive symptoms declined in many studies both in the active drug group and in the placebo group. Only four trials showed a statistically significant difference between an active drug and a placebo in decreasing depressive symptoms. Psychosocial support was arranged in all trials, which may explain the positive effects of placebo and gives support to the conclusion about the importance of psychosocial treatment of depression. Antidepressive drugs may be effective in treating major depression among the aged suffering from memory disturbances or dementia, but more studies are needed. The side effects of tricyclic antidepressants are problematic in the aged, and they should not be prescribed.
目的是对抗抑郁药物对伴有记忆障碍或痴呆的老年人抑郁症的影响进行系统评价。在Medline(PubMed)和Cochrane数据库中检索了1980年至2009年发表的随机对照试验(RCT)。资料包括11项原始RCT。在许多研究中,活性药物组和安慰剂组的抑郁症状均有所减轻。只有四项试验显示活性药物与安慰剂在减轻抑郁症状方面存在统计学上的显著差异。所有试验均安排了心理社会支持,这可能解释了安慰剂的积极作用,并支持了抑郁症心理社会治疗重要性的结论。抗抑郁药物可能对患有记忆障碍或痴呆的老年人的重度抑郁症有效,但还需要更多的研究。三环类抗抑郁药的副作用在老年人中存在问题,不应开具此类药物。