Shah Drishti, Vaidya Varun, Patel Amit, Borovicka Mary, Goodman Monica-Holiday
Department of Pharmaceutical Systems and Policy,School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA.
Division of Health Outcomes and Socio-economic Sciences, Department of Pharmacy Practice, College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, OH, USA.
Qual Life Res. 2017 Apr;26(4):969-980. doi: 10.1007/s11136-016-1417-0. Epub 2016 Sep 26.
Effectiveness of antidepressants is generally comparable between and within classes. However, real-world studies on antidepressant treatment and its consequences on the overall quality of life and mental health of individuals are limited. The purpose of this study was to examine the association of specific class of antidepressants with the health-related quality of life, psychological distress and self-reported mental health of individuals suffering from depression who are on monotherapy.
This retrospective, longitudinal study included individuals with depression who were on antidepressant monotherapy, using data from 2008 to 2011 Medical Expenditure Panel Survey (MEPS). Changes in health-related quality of life, self-reported mental health and psychological distress over a year's time were observed. A multinomial logistic regression model was built to examine the association between the class of antidepressant medications and the dependent variables.
A total of 688 adults met the study inclusion criteria. No significant difference was observed in the change in Physical Component Summary (PCS), self-reported mental health and psychological distress based on the class of antidepressants. However, individuals on serotonin-norepinephrine reuptake inhibitors (SNRIs) (OR 0.337, 95 % CI 0.155-0.730) were significantly less likely to show improvement on Mental Component Summary (MCS) scores as compared to those on selective serotonin reuptake inhibitors (SSRIs).
The study findings suggest that practitioners should be aware of the differences in the health-related quality of life of those taking SSRIs versus other classes of antidepressants. Further research needs to be done to determine the reason for SSRIs to show greater improvement on mental health as compared to SNRIs.
抗抑郁药在不同类别之间以及同类药物内部的疗效通常具有可比性。然而,关于抗抑郁药治疗及其对个体整体生活质量和心理健康影响的真实世界研究有限。本研究的目的是探讨特定类别的抗抑郁药与接受单一疗法的抑郁症患者的健康相关生活质量、心理困扰和自我报告的心理健康之间的关联。
这项回顾性纵向研究纳入了接受抗抑郁药单一疗法的抑郁症患者,使用了2008年至2011年医疗支出面板调查(MEPS)的数据。观察了一年时间内健康相关生活质量、自我报告的心理健康和心理困扰的变化。建立了多项逻辑回归模型来检验抗抑郁药物类别与因变量之间的关联。
共有688名成年人符合研究纳入标准。基于抗抑郁药的类别,在身体成分总结(PCS)、自我报告的心理健康和心理困扰的变化方面未观察到显著差异。然而,与接受选择性5-羟色胺再摄取抑制剂(SSRIs)治疗的患者相比,接受5-羟色胺-去甲肾上腺素再摄取抑制剂(SNRIs)治疗的患者在心理成分总结(MCS)评分上改善的可能性显著更低(比值比0.337,95%置信区间0.155 - 0.730)。
研究结果表明,从业者应意识到服用SSRIs与其他类别抗抑郁药的患者在健康相关生活质量方面的差异。需要进一步研究以确定与SNRIs相比,SSRIs在心理健康方面表现出更大改善的原因。