Department of Evidence-based Medicine and Clinical Epidemiology, Danube University, Karl Dorrek-Strasse 30, 3500, Krems, Austria.
Curr Psychiatry Rep. 2012 Aug;14(4):360-9. doi: 10.1007/s11920-012-0283-x.
Clinicians can choose among various second-generation antidepressants for treating depressive disorders, such as major depressive disorder, subsyndromal depression, or dysthymia. Systematic reviews indicate that available drugs differ in frequency of administration, costs, and the risks of some adverse events but have similar efficacy for treating major depressive disorder. Furthermore, evidence does not support the choice of one antidepressant over another based on accompanying symptoms, such anxiety, insomnia, or pain. Available studies provide little guidance for clinicians about the benefits of second-generation antidepressants for treating dysthymia and subsyndromal depression. Evidence is also unclear about the comparative risks of serious adverse events, such as suicidality, seizures, fractures, increased bleeding, or serotonin syndrome. This article summarizes the best available evidence regarding comparative benefits and harms of second-generation antidepressants for treating depressive disorders.
临床医生可以在各种第二代抗抑郁药中进行选择，用于治疗抑郁症，如重度抑郁症、亚综合征性抑郁或恶劣心境。系统评价表明，现有药物在给药频率、成本和某些不良事件风险方面存在差异，但在治疗重度抑郁症方面具有相似的疗效。此外，没有证据支持根据伴随症状（如焦虑、失眠或疼痛）选择一种抗抑郁药而不是另一种抗抑郁药。现有研究几乎没有为临床医生提供关于第二代抗抑郁药治疗恶劣心境和亚综合征性抑郁的获益的指导。关于严重不良事件（如自杀意念、癫痫发作、骨折、出血增加或血清素综合征）的相对风险的证据也不清楚。本文总结了关于第二代抗抑郁药治疗抑郁症的相对获益和危害的最佳现有证据。
