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非典型抗精神病药治疗创伤后应激障碍的疗效和可接受性:随机、双盲、安慰剂对照临床试验的荟萃分析。

Efficacy and acceptability of atypical antipsychotics for the treatment of post-traumatic stress disorder: a meta-analysis of randomized, double-blind, placebo-controlled clinical trials.

机构信息

Medical Psychology Division, Chinese PLA General Hospital & Medical School PLA, Beijing, China.

Medical Psychology Division, Chinese PLA General Hospital & Medical School PLA, Beijing, China; Department of Psychiatry, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China; Department of Psychiatry, Shenzhen Key laboratory of psychological health center, Shenzhen, China.

出版信息

Psychiatry Res. 2014 Nov 30;219(3):543-9. doi: 10.1016/j.psychres.2014.05.027. Epub 2014 Jun 2.

Abstract

As some evidences demonstrated that atypical antipsychotics (AA) may be efficacious in treating post-traumatic stress disorder (PTSD), we preformed a meta-analysis of randomized, double-blind, placebo-controlled clinical trials (RCTs) of AAs for the treatment of PTSD. Two hundred and fifty one papers were searched and screened. Eight RCTs met the inclusion criteria. AAs may be superior to placebo in the treatment of PTSD, as indicated by the changes in Clinician Administered PTSD Scale (CAPS) total scores (weighted mean differences (WMD)=-5.89, 95% confidence interval (CI) [-9.21, -2.56], P=0.0005) and also in CAPS subscale intrusion (WMD=-2.58, 95% CI[-3.83, -1.33], P<0.0001 ) and subscale hyperarousal (WMD=-2.94, 95% CI[-5.45, -0.43], P=0.02). The acceptability measured by dropout rates between AAs and placebo showed no statistical difference (OR=1.24, 95%CI [0.78, 1.97], P=0.36). PTSD symptom cluster, especially in intrusion and hyperarousal. However, we should be careful to generalize the conclusion because of the small number of included trails. We expect more RCTs will be done in the future so as to clarify the specific value of AAs for PTSD.

摘要

由于一些证据表明,非典型抗精神病药(AA)可能对治疗创伤后应激障碍(PTSD)有效,我们对 AA 治疗 PTSD 的随机、双盲、安慰剂对照临床试验(RCT)进行了荟萃分析。共搜索和筛选了 251 篇论文。符合纳入标准的有 8 项 RCT。AA 在治疗 PTSD 方面可能优于安慰剂,这表现在临床医生管理的 PTSD 量表(CAPS)总分的变化上(加权均数差(WMD)=-5.89,95%置信区间(CI)[-9.21,-2.56],P=0.0005),以及 CAPS 入侵亚量表(WMD=-2.58,95%CI[-3.83,-1.33],P<0.0001)和高警觉亚量表(WMD=-2.94,95%CI[-5.45,-0.43],P=0.02)。AA 与安慰剂之间的脱落率衡量的可接受性没有统计学差异(OR=1.24,95%CI [0.78,1.97],P=0.36)。PTSD 症状群,尤其是入侵和高警觉。然而,由于纳入的试验数量较少,我们应该谨慎推广这一结论。我们希望未来会有更多的 RCT 来阐明 AA 对 PTSD 的具体价值。

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