创伤后应激障碍的药物治疗：系统评价和荟萃分析。
Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis.
机构信息
Mathew Hoskins, MRCPsych, Jennifer Pearce, BSc, Andrew Bethell, BSc, Liliya Dankova, BSc, Cardiff University, Cardiff, UK; Corrado Barbui, MD, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy; Wietse A. Tol, PhD, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Mark van Ommeren, PhD, World Health Organization, Geneva, Switzerland; Joop de Jong, MD, PhD, Vrije Universiteit, Amsterdam, The Netherlands; Soraya Seedat, MD, Stellenbosch University, Stellenbosch, South Africa; Hanhui Chen, MD, Shanghai Mental Health Centre, Shanghai Jiaotong University, Shanghai, China; Jonathan I. Bisson, DM, Cardiff University, Cardiff, UK.
出版信息
Br J Psychiatry. 2015 Feb;206(2):93-100. doi: 10.1192/bjp.bp.114.148551.
BACKGROUND
Pharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.
AIMS
To determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.
METHOD
A systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.
RESULTS
Selective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference -0.23, 95% CI -0.33 to -0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.
CONCLUSIONS
Some drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.
背景
尽管对其疗效存在疑问，但药物治疗在创伤后应激障碍（PTSD）中仍被广泛应用。
目的
确定各种类型的药物治疗（包括单一药物治疗）在减轻 PTSD 症状方面的疗效，并评估其可接受性。
方法
进行了一项随机对照试验的系统评价和荟萃分析，共纳入 51 项研究。
结果
选择性 5-羟色胺再摄取抑制剂在减轻 PTSD 症状方面被发现明显优于安慰剂，但效应量较小（标准化均数差-0.23，95%置信区间-0.33 至-0.12）。对于两种或两种以上试验中与安慰剂相比的个别药物，我们发现氟西汀、帕罗西汀和文拉法辛在疗效方面有较小但有统计学意义的证据。
结论
一些药物对 PTSD 症状有轻微的积极影响，且可接受。氟西汀、帕罗西汀和文拉法辛可能被认为是该疾病的潜在治疗药物。对于大多数药物，关于 PTSD 疗效的证据不足，这表明需要在该领域进行更多的研究。
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