Department of Psychiatry of Yale University, New Haven, CT, United States.
Yale Child Study Center, New Haven, CT, United States.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jun 8;84(Pt A):282-293. doi: 10.1016/j.pnpbp.2017.12.012. Epub 2017 Dec 20.
The goal of this meta-analysis was to quantify the risk of dry mouth associated with commonly prescribed antidepressant agents and examine the potential implications of medication class, dose, and pharmacodynamics and dose on risk of treatment-induced dry mouth.
A PubMed search was conducted to identify double-blind, randomized, placebo-controlled trials examining the efficacy and tolerability of second generation antidepressant medications for adults with depressive disorders, anxiety disorders, and OCD.
A random-effects meta-analysis was used to quantify the pooled risk ratio of treatment-emergent dry mouth with second generation antidepressants compared to placebo. Stratified subgroup analysis and meta-regression was utilized to further examine the effects antidepressant agent, class, dosage, indication, and receptor affinity profile on the measured risk of dry mouth.
99 trials involving 20,868 adults. SNRIs (Relative Risk (RR)=2.24, 95% Confidence Interval (CI): 1.95-2.58, z=11.2, p<0.001) were associated with a significantly greater risk of dry mouth (test for subgroup differences χ=7.6, df=1; p=0.006) compared to placebo than SSRIs (RR=1.65, 95% CI: 1.39-1.95, z=5.8, p<0.001). There was a significant difference found in the risk of dry mouth between diagnostic indications within the SNRI class (test for subgroup differences χ=9.63, df=1; p=0.002). Anxiety diagnoses (RR=2.78, 95% CI: 2.29-3.38, z=10.32, p<0.001) were associated with a greater risk of dry mouth compared to depression (RR=1.80, 95% CI: 1.48-2.18, z=5.85, p<0.001). Decreased affinity for Alpha-1 (PE=0.18, 95% CI: 0.07-0.28, z=3.26, p=0.001) and Alpha-2 (PE=0.49, 95% CI: 0.22-0.75, z=3.64, p<0.001) receptors and SERT (PE=0.07, 95% CI: 0.01-0.14, z=2.10, p<0.05) was significantly associated with increased risk of dry mouth.
The current meta-analysis suggests that SSRIs, SNRIs, and atypical antidepressants are all associated with varying degrees of increased risk of dry mouth. SNRIs were associated with a significantly greater risk of dry mouth compared to SSRIs.
本荟萃分析的目的是量化与常用抗抑郁药相关的口干风险，并研究药物类别、剂量和药物动力学以及剂量对治疗引起的口干风险的潜在影响。
进行了一项 PubMed 检索，以确定评估第二代抗抑郁药治疗成人抑郁障碍、焦虑障碍和强迫症的疗效和耐受性的双盲、随机、安慰剂对照试验。
使用随机效应荟萃分析来量化与第二代抗抑郁药相比，治疗引起的口干的风险比。利用分层亚组分析和荟萃回归进一步研究抗抑郁药、药物类别、剂量、适应证和受体亲和力特征对测量的口干风险的影响。
99 项涉及 20868 名成年人的试验。SNRIs（相对风险 (RR)=2.24，95%置信区间 (CI):1.95-2.58，z=11.2，p<0.001）与显著更高的口干风险相关（亚组差异检验 χ=7.6，df=1；p=0.006）与 SSRI（RR=1.65，95%CI：1.39-1.95，z=5.8，p<0.001）相比。在 SNRI 类别内的诊断适应证之间发现了口干风险的显著差异（亚组差异检验 χ=9.63，df=1；p=0.002）。与抑郁相比，焦虑诊断（RR=2.78，95%CI：2.29-3.38，z=10.32，p<0.001）与口干风险增加相关（RR=1.80，95%CI：1.48-2.18，z=5.85，p<0.001）。对 Alpha-1（PE=0.18，95%CI：0.07-0.28，z=3.26，p=0.001）和 Alpha-2（PE=0.49，95%CI：0.22-0.75，z=3.64，p<0.001）受体和 SERT（PE=0.07，95%CI：0.01-0.14，z=2.10，p<0.05）亲和力降低与口干风险增加显著相关。
目前的荟萃分析表明，SSRIs、SNRIs 和非典型抗抑郁药都与不同程度的口干风险增加相关。与 SSRI 相比，SNRI 与口干风险显著增加相关。
