Yousefi Faeze, Kamyab Parnia, Fakhraei Bahareh, Farjam Mojtaba, Rezaei Shahla, Mahmoudi Seyed Sasan, Karimimoghadam Zeinab, Tabrizi Reza, Jaafari Nematollah
Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran.
Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Galen Med J. 2023 Dec 18;12:e3153. doi: 10.31661/gmj.v12i.3153. eCollection 2023.
Multiple sclerosis (MS) affects the central nervous system and creates plaques by demyelination of neurons. Several studies have investigated the effect of selective serotonin reuptake inhibitors (SSRIs) on MS clinical courses. The current meta-analysis was conducted to determine the effect of SSRIs on neurological and depressive symptoms of MS disease based on a systematic review and meta-analysis of randomized controlled trials.
We searched the PubMed/Medline, Scopus, EMBASE, Google scholar, Web of Science, and Cochrane Library until June 2023. The effects of SSRI were assessed through indictors such as symbol digit modalities test (SDMT), expanded disability status scale (EDSS), modified fatigue impact scale (MFIS), and Beck's depression inventory/psychiatric (BDI).
Considering the inclusion criteria, seven articles (including eight trials) were included in this review. The meta-analysis results demonstrated that SSRIs treatments did not have significant effects on indicators of neurological and depressive symptoms, such as SDMT (Weighted Mean Difference (WMD)=-0.87; 95% CI, -7.74, 5.99, P=0.35; I2=0.0%), EDSS (WMD=-0.05; 95% CI, -0.24, 0.14, P=0.62; I2=0.0%), MFIS (WMD=5.29; 95% CI, -18.10, 28.68, P=0.21; I2=0.0%), and BDI (WMD=-0.47; 95% CI, -2.61, 1.67, P=0.67; I2=32.05%) in patients with MS compared with controls.
This study shows that the consumption of SSRIs in MS patients compared to the control group does not bring about a significant change in the indices related to neurological and depressive symptoms. Further meta-analyses are required in order to provide stronger evidence in the future.
多发性硬化症（MS）会影响中枢神经系统，并通过神经元脱髓鞘形成斑块。多项研究探讨了选择性5-羟色胺再摄取抑制剂（SSRIs）对MS临床病程的影响。本荟萃分析旨在基于对随机对照试验的系统评价和荟萃分析，确定SSRIs对MS疾病神经和抑郁症状的影响。
我们检索了截至2023年6月的PubMed/Medline、Scopus、EMBASE、谷歌学术、科学网和Cochrane图书馆。通过符号数字模态测试（SDMT）、扩展残疾状态量表（EDSS）、改良疲劳影响量表（MFIS）以及贝克抑郁量表/精神科（BDI）等指标评估SSRI的效果。
根据纳入标准，本综述纳入了7篇文章（包括8项试验）。荟萃分析结果表明，与对照组相比，SSRIs治疗对MS患者神经和抑郁症状指标没有显著影响，如SDMT（加权平均差（WMD）=-0.87；95%置信区间，-7.74，5.99，P=0.35；I2=0.0%）、EDSS（WMD=-0.05；95%置信区间，-0.24，0.14，P=0.62；I2=0.0%）、MFIS（WMD=5.29；95%置信区间，-18.10，28.68，P=0.21；I2=0.0%）和BDI（WMD=-0.47；95%置信区间，-2.61，1.67，P=0.67；I2=32.05%）。
本研究表明，与对照组相比，MS患者服用SSRIs不会使神经和抑郁症状相关指标发生显著变化。未来需要进一步进行荟萃分析以提供更有力的证据。
