Sleep Research Centre, Department of Neurology I.C., Oasi Research Institute - IRCCS, Troina, Italy.
Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Neurosci Biobehav Rev. 2023 May;148:105126. doi: 10.1016/j.neubiorev.2023.105126. Epub 2023 Mar 11.
Studies explicitly reporting data concerning the evaluation of the effect of antidepressants on the periodic leg movements during sleep (PLMS) index obtained by polysomnography were reviewed and selected. A random-effects model meta-analysis was carried out. The level of evidence was also assessed for each paper. Twelve studies were included in the final meta-analysis, seven interventional and five observational. Most studies were characterized by Level III evidence (non-randomized controlled trials), with the exception of four studies, which were classified as Level IV (case series, case-control, or historically controlled studies). Selective serotonin reuptake inhibitors (SSRIs) were used in seven studies. The analysis of the assessments involving SSRIs or venlafaxine showed an overall large effect size, clearly much larger than that obtained with studies using other antidepressants. Heterogeneity was substantial. This meta-analysis confirms the previous reports on the increase in PLMS often associated with the use of SSRIs (and venlafaxine); however, the absent or smaller effect of the other categories of antidepressants needs to be confirmed by more numerous and better controlled studies.
对明确报告抗抑郁药对多导睡眠图（PSG）获得的周期性肢体运动（PLMS）指数的影响评估数据的研究进行了回顾和选择。进行了随机效应模型荟萃分析。还对每篇论文的证据水平进行了评估。最终荟萃分析纳入了 12 项研究，其中 7 项为干预性研究，5 项为观察性研究。大多数研究的证据水平为 III 级（非随机对照试验），但有 4 项研究为 IV 级（病例系列、病例对照或历史对照研究）。有 7 项研究使用了选择性 5-羟色胺再摄取抑制剂（SSRIs）。对涉及 SSRIs 或文拉法辛的评估进行分析，发现总体效应量较大，明显大于使用其他抗抑郁药的研究。异质性很大。这项荟萃分析证实了先前关于 SSRIs（和文拉法辛）使用常与 PLMS 增加相关的报告；然而，其他类别的抗抑郁药的效果缺失或较小，需要更多、控制更好的研究来证实。
