Rogers Jonathan, Taylor Matthew J
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
J Psychopharmacol. 2017 Mar;31(3):387-388. doi: 10.1177/0269881116672099.
It is well recognized that medications have an important role to play in preventing relapse in bipolar disorder. The impact these treatments have on rates of admission to hospital in particular has been less well studied. We combined data on hospitalization from 11 randomized controlled trials in a network meta-analysis. We found that the published evidence demonstrates significant reductions in admission rates compared to placebo from lithium (risk ratio (RR) 0.44, 95% confidence interval (CI) 0.32-0.59), valproate (RR 0.50, 95% CI 0.28-0.90), a combination of lithium and valproate (RR 0.50, 95% CI 0.28-0.90), carbamazepine (RR 0.46, 95% CI 0.29-0.73) and olanzapine (RR 0.27, 95% CI 0.16-0.43). The evidence base contributing to these estimates remains fairly small, leading to broad confidence intervals for estimates of effect. More precise estimates could be obtained if unpublished outcomes data from other trials in this area became available. Several pharmacological treatments appear to be effective at reducing the need for hospital admission in people with bipolar disorder.
众所周知，药物在预防双相情感障碍复发方面发挥着重要作用。然而，这些治疗方法对住院率的影响，尤其是这方面的研究较少。我们在一项网状荟萃分析中合并了来自11项随机对照试验的住院数据。我们发现，已发表的证据表明，与安慰剂相比，锂盐（风险比（RR）0.44，95%置信区间（CI）0.32 - 0.59）、丙戊酸盐（RR 0.50，95% CI 0.28 - 0.90）、锂盐与丙戊酸盐联合使用（RR 0.50，95% CI 0.28 - 0.90）、卡马西平（RR 0.46，95% CI 0.29 - 0.73）和奥氮平（RR 0.27，95% CI 0.16 - 0.43）的住院率显著降低。构成这些估计值的证据基础仍然相当小，导致效应估计的置信区间较宽。如果能获得该领域其他试验未发表的结果数据，就可以得到更精确的估计值。几种药物治疗似乎对减少双相情感障碍患者的住院需求有效。
