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原发性脑肿瘤患者抑郁症的药物治疗

Pharmacological treatment of depression in patients with a primary brain tumour.

作者信息

Rooney Alasdair, Grant Robin

机构信息

Edinburgh Centre for Neuro-Oncology (ECNO), Western General Hospital, Edinburgh, UK.

出版信息

Cochrane Database Syst Rev. 2013 May 31;2013(5):CD006932. doi: 10.1002/14651858.CD006932.pub3.

Abstract

BACKGROUND

This is an updated version of the original Cochrane review published in Issue 3, 2010.Patients with a primary brain tumour often experience depression, for which drug treatment may be prescribed. However, these patients are also at high risk of epileptic seizures, cognitive impairment and fatigue, all of which are potential side effects of antidepressants. The benefit, or harm, of pharmacological treatment of depression in brain tumour patients is unclear.

OBJECTIVES

To assess the benefits and harms of pharmacological treatment of depression in patients with a primary brain tumour.

SEARCH METHODS

We updated the search to include the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10), MEDLINE to October 2012, EMBASE to October 2012 and PsycINFO to October 2012. We searched the British Nursing Index, LILACS, PSYNDEX, the NHS National Research Register, the NHS Centre for Reviews and Dissemination's Database of Abstracts of Reviews of Effectiveness (DARE) and Web of Knowledge (covering Science Scisearch, Social Sciences Citation Index and Biological Abstracts) for the original review (to July 2009). In the original review we also handsearched Neuro-oncology, the Journal of Neuro-oncology, the Journal of Neurology, Neurosurgery and Psychiatry and the Journal of Clinical Oncology (July 1999 to June 2009) and wrote to all the pharmaceutical companies manufacturing antidepressants for use in the UK.

SELECTION CRITERIA

We searched for all randomised controlled trials (RCTs), controlled clinical trials, cohort studies and case-control studies of any pharmacological treatment of depression in patients with a histologically diagnosed primary brain tumour.

DATA COLLECTION AND ANALYSIS

No studies met the inclusion criteria.

MAIN RESULTS

We found no eligible studies evaluating the benefits of any pharmacological treatment of depression in brain tumour patients.

AUTHORS' CONCLUSIONS: No high-quality studies have examined the value of pharmacological treatment of depression in patients with a primary brain tumour. RCTs and detailed prospective studies are required to inform the effective pharmacological treatment of this common and important complication of brain tumours. Since the last version of this review none of the new relevant studies have provided additional information to change these conclusions.

摘要

背景

这是2010年第3期发表的Cochrane系统评价的更新版本。原发性脑肿瘤患者常出现抑郁症状,可能会接受药物治疗。然而,这些患者也有癫痫发作、认知障碍和疲劳的高风险,而这些都是抗抑郁药的潜在副作用。脑肿瘤患者抑郁的药物治疗的益处或危害尚不清楚。

目的

评估原发性脑肿瘤患者抑郁的药物治疗的益处和危害。

检索方法

我们更新了检索,纳入Cochrane对照试验中心注册库(CENTRAL)(《Cochrane图书馆》2012年第10期)、截至2012年10月的MEDLINE、截至2012年10月的EMBASE和截至2012年10月的PsycINFO。我们检索了英国护理索引、拉丁美洲和加勒比卫生科学数据库、德国心理学文摘数据库、英国国家医疗服务体系国家研究注册库、英国国家医疗服务体系综述与传播中心的有效性综述摘要数据库(DARE)以及知识网络(涵盖科学引文索引、社会科学引文索引和生物学文摘)以获取原始综述(至2009年7月)。在原始综述中,我们还手工检索了《神经肿瘤学》《神经肿瘤学杂志》《神经病学、神经外科学与精神病学杂志》和《临床肿瘤学杂志》(1999年7月至2009年6月),并致函所有在英国生产用于治疗抑郁症的抗抑郁药的制药公司。

选择标准

我们检索了所有关于组织学诊断为原发性脑肿瘤患者抑郁的任何药物治疗的随机对照试验(RCT)、对照临床试验、队列研究和病例对照研究。

数据收集与分析

没有研究符合纳入标准。

主要结果

我们未发现评估脑肿瘤患者抑郁的任何药物治疗益处的合格研究。

作者结论

尚无高质量研究考察原发性脑肿瘤患者抑郁的药物治疗价值。需要进行随机对照试验和详细的前瞻性研究,为脑肿瘤这种常见且重要并发症的有效药物治疗提供依据。自本综述的上一版本以来,新的相关研究均未提供额外信息以改变这些结论。

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本文引用的文献

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Pharmacological treatment of depression in patients with a primary brain tumour.原发性脑肿瘤患者抑郁症的药物治疗
Cochrane Database Syst Rev. 2010 Mar 17(3):CD006932. doi: 10.1002/14651858.CD006932.pub2.
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The relationships between depression and brain tumors.抑郁症与脑肿瘤之间的关系。
J Neurooncol. 2009 Sep;94(2):153-61. doi: 10.1007/s11060-009-9825-4. Epub 2009 Mar 5.
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Interventions for treating depression after stroke.中风后抑郁症的治疗干预措施。
Cochrane Database Syst Rev. 2008 Oct 8(4):CD003437. doi: 10.1002/14651858.CD003437.pub3.
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Malignant gliomas in adults.成人恶性胶质瘤
N Engl J Med. 2008 Jul 31;359(5):492-507. doi: 10.1056/NEJMra0708126.
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Work productivity in brain tumor survivors.脑肿瘤幸存者的工作效率
J Occup Environ Med. 2007 Jul;49(7):803-11. doi: 10.1097/JOM.0b013e318095a458.

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