Moćko Paweł, Śladowska Katarzyna, Kawalec Paweł, Babii Yana, Pilc Andrzej
Health Policy and Management Department, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska 8, 31-066 Kraków, Poland.
Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska 8, 31-066 Kraków, Poland.
Biomedicines. 2023 Sep 26;11(10):2636. doi: 10.3390/biomedicines11102636.
Major depressive disorder is one of the most severe mental disorders. It strongly impairs daily functioning, and, in extreme cases, it can lead to suicide. Although different treatment options are available for patients with depression, there is an ongoing search for novel therapeutic agents, such as scopolamine (also known as hyoscine), that would offer higher efficacy, a more rapid onset of action, and a more favorable safety profile. The aim of our study was to review the current clinical evidence regarding the use of scopolamine, a promising therapeutic option in the treatment of depression. A systematic literature search was performed using PubMed, Embase, and CENTRAL databases up to 5 June 2023. We included randomized placebo-controlled or head-to-head clinical trials that compared the clinical efficacy and safety of scopolamine in the treatment of major depressive disorder. Two reviewers independently conducted the search and study selection and rated the risk of bias for each study. Four randomized controlled trials were identified in the systematic review. The included studies investigated the use of scopolamine administered as an oral, intramuscular, or intravenous drug, alone or in combination with other antidepressants. The results indicated that scopolamine exerts antidepressant effects of varying intensity. We show that not all studies confirmed a statistically and clinically significant reduction of depressive symptoms vs. placebo. A broader perspective on scopolamine use in antidepressant treatment should be confirmed in subsequent large randomized controlled trials assessing both effectiveness and safety. Therefore, studies directly comparing the effectiveness of scopolamine depending on the route of administration are required.
重度抑郁症是最严重的精神障碍之一。它严重损害日常功能，在极端情况下，会导致自杀。尽管抑郁症患者有不同的治疗选择，但人们一直在寻找新型治疗药物，如东莨菪碱（也称为海索那明），它能提供更高的疗效、更快的起效速度和更良好的安全性。我们研究的目的是回顾目前关于东莨菪碱使用的临床证据，东莨菪碱是治疗抑郁症的一种有前景的治疗选择。使用PubMed、Embase和CENTRAL数据库进行了系统的文献检索，检索截至2023年6月5日。我们纳入了比较东莨菪碱治疗重度抑郁症的临床疗效和安全性的随机安慰剂对照或头对头临床试验。两名评审员独立进行检索和研究筛选，并对每项研究的偏倚风险进行评级。在系统评价中确定了四项随机对照试验。纳入的研究调查了单独或与其他抗抑郁药联合使用的口服、肌肉注射或静脉注射东莨菪碱的情况。结果表明，东莨菪碱具有不同强度的抗抑郁作用。我们发现并非所有研究都证实与安慰剂相比，抑郁症状在统计学和临床上有显著减轻。在随后评估有效性和安全性的大型随机对照试验中，应确认对东莨菪碱用于抗抑郁治疗的更广泛观点。因此，需要进行直接比较东莨菪碱不同给药途径有效性的研究。
