Guo Shengyu, Yang Yan, Pei Xi Jun, Liu Fei Yue
Department of economics and management, ChangSha University.
Department of Social Medicine and health management, Xiangya School of Public Health, Central South University.
Medicine (Baltimore). 2020 Feb;99(7):e19133. doi: 10.1097/MD.0000000000019133.
To compare the therapeutic effect of 6 SSRIs among the Chinese senile depression patients. And drug-induced nausea leads to low compliance in elderly depression patients in China, it is urgent to assess the safety of 6 SSRIs with respect to induced-nausea among the Chinese senile depression patients.
In the present study, a network of meta-analysis was conducted to assess the efficacy of 6 SSRIs among the Chinese senile depression patients, in addition, the safety of 6 SSRIs with respect to induced-nausea among the Chinese senile depression patients was also evaluated. PubMed, Embase databases, WanFang, CNKI, ChongqingWeiPu were searched for the related articles. The primary outcome of this study were the number of effective cases of SSRIs and the number of cases of nausea caused by SSRIs in Chinese elderly depressed patients. Odds ratios (ORs) and corresponding 95% confidence intervals(95%CIs) were calculated within pairwise and network meta-analysis.
Twenty eight trials were identified, including 2246 patients, the network meta-analysis indicated that Escitalopram was associated with a lower risk of nausea compared Paroxetine (odds ratios 0.49, 95%CI = 0.34-0.69) when they were used in Chinese elderly depressed patients. Escitalopram also exhibited distinct advantages compared other SSRIs.In terms of drug efficacy, Escitalopram was significantly superior to Paroxetine (OR = 2.26, 95%CI = 1.55-3.37).
The rank of SSRIs with respect to induced-nausea was: Combination of EP > Fluoxetine > Paroxetine > Citalopram > Sertraline > Fluvoxamine > Escitalopram, respectively.
比较6种选择性5-羟色胺再摄取抑制剂(SSRIs)对中国老年抑郁症患者的治疗效果。在中国,药物性恶心导致老年抑郁症患者的依从性较低,因此迫切需要评估6种SSRIs在中国老年抑郁症患者中引起恶心的安全性。
在本研究中,进行了一项网状荟萃分析,以评估6种SSRIs对中国老年抑郁症患者的疗效,此外,还评估了6种SSRIs在中国老年抑郁症患者中引起恶心的安全性。检索了PubMed、Embase数据库、万方、知网、重庆维普等相关文章。本研究的主要结局是中国老年抑郁症患者中SSRIs的有效病例数和由SSRIs引起的恶心病例数。在成对和网状荟萃分析中计算比值比(OR)和相应的95%置信区间(95%CI)。
共纳入28项试验,包括2246例患者,网状荟萃分析表明,在中国老年抑郁症患者中使用时,艾司西酞普兰引起恶心的风险低于帕罗西汀(比值比0.49,95%CI=0.34-0.69)。与其他SSRIs相比,艾司西酞普兰也表现出明显的优势。在药物疗效方面,艾司西酞普兰显著优于帕罗西汀(OR=2.26,95%CI=1.55-3.37)。
SSRIs引起恶心的排序依次为:艾司西酞普兰>氟西汀>帕罗西汀>西酞普兰>舍曲林>氟伏沙明>艾司西酞普兰。