Jonathan Rabinowitz, PhD, Nomi Werbeloff, PhD, School of Social Work, Ramat Gan, Bar Ilan University, Israel; Francine S. Mandel, PhD, Pfizer Development Operations, New York, USA; François Menard, MD, Lundbec Research Department, Paris, France; Lauren Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, USA; Shitij Kapur, MD, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
Jonathan Rabinowitz, PhD, Nomi Werbeloff, PhD, School of Social Work, Ramat Gan, Bar Ilan University, Israel; Francine S. Mandel, PhD, Pfizer Development Operations, New York, USA; François Menard, MD, Lundbec Research Department, Paris, France; Lauren Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, USA; Shitij Kapur, MD, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
Br J Psychiatry. 2016 Nov;209(5):427-428. doi: 10.1192/bjp.bp.115.173906. Epub 2016 May 19.
Several often-cited meta-analyses have reported that the efficacy of antidepressant medications depends on the severity of depression. They found that drug-placebo differences increased as a function of initial severity, which was attributed to decreased responsiveness to placebo among patients with severe depression rather than to increased responsiveness to medication. We retested this using patient-level data and also undertaking a meta-analysis of trial-level data from 34 randomised placebo controlled trials (n = 10 737) from the NEWMEDS registry. Although our trial-level data support prevous findings, patient-level data did not show any significant effect of initial depression severity on drug v. placebo difference.
几项常被引用的荟萃分析报告称，抗抑郁药物的疗效取决于抑郁的严重程度。他们发现，药物与安慰剂的差异随着初始严重程度的增加而增加，这归因于重度抑郁症患者对安慰剂的反应性降低，而不是对药物的反应性增加。我们使用患者水平的数据进行了重新测试，并对来自 NEWMEDS 登记处的 34 项随机安慰剂对照试验（n = 10737）的试验水平数据进行了荟萃分析。尽管我们的试验水平数据支持以前的发现，但患者水平的数据并没有显示初始抑郁严重程度对药物与安慰剂差异的任何显著影响。
