Nawaz Amber, Mamoon Beena, Batool Tashbiha E, Khattak Muhammad Iftikhar, Amir Fehmida, Akbar Amna, Khan Shahid
Anatomy Department, Azad Jammu and Kashmir Medical College, Muzaffarabad, PAK.
Department of Psychiatry, Kulsoom International Hospital, Islamabad, PAK.
Cureus. 2024 Dec 24;16(12):e76318. doi: 10.7759/cureus.76318. eCollection 2024 Dec.
Introduction Depression is a prevalent and debilitating condition that often requires long-term medication management. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used but have limitations in efficacy and tolerability for some individuals. New antidepressant drugs targeting multiple pathways have shown potential in recent research. This study aimed to evaluate the efficacy, quality of life (QoL) improvements, and adverse effect profiles of SSRIs, SNRIs, and novel agents in patients with depression. Methodology This prospective cohort study was conducted at inpatient and outpatient psychiatric units of Abbas Institute of Medical Sciences, over six months, from March to August 2024, enrolling 300 patients diagnosed with depression. Participants were evenly divided into three treatment groups: SSRIs, SNRIs, and novel agents. Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D), and QoL was measured using standardized QoL scores. Statistical analyses, including paired t-tests, Analysis of Variance (ANOVA), and chi-square tests, were performed for comparison. Results All groups showed notable declines in Hamilton Depression Rating Scale (HAM-D) scores; the group with the new agents showed the largest mean HAM-D reduction: (17.2, p < 0.001). All groups' QoL rose; the mean rise in QoL ratings among the novel agents' group (19.7, p < 0.01) was the highest. Compared to SSRIs (84%) and SNRIs (82%), the novel agent group likewise had the lowest incidence of side effects, which raised the adherence rate (91%). Conclusion Novel antidepressants showed better efficacy and tolerability than SSRIs and SNRIs, therefore enhancing QoL and adherence. These findings imply that for those who do not react well to conventional treatments, novel medicines could be a good substitute. Confirming these conclusions will require more long-term, multi-center research.
引言
抑郁症是一种常见且使人衰弱的疾病，通常需要长期的药物治疗管理。选择性5-羟色胺再摄取抑制剂（SSRIs）和5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）是常用药物，但对某些个体而言，在疗效和耐受性方面存在局限性。针对多种途径的新型抗抑郁药物在最近的研究中显示出潜力。本研究旨在评估SSRIs、SNRIs和新型药物对抑郁症患者的疗效、生活质量（QoL）改善情况及不良反应特征。
方法
这项前瞻性队列研究于2024年3月至8月在阿巴斯医学科学研究所的住院和门诊精神科进行，为期六个月，招募了300名被诊断为抑郁症的患者。参与者被平均分为三个治疗组：SSRIs组、SNRIs组和新型药物组。使用汉密尔顿抑郁量表（HAM-D）评估抑郁严重程度，并使用标准化的QoL评分测量生活质量。进行了包括配对t检验、方差分析（ANOVA）和卡方检验在内的统计分析以作比较。
结果
所有组的汉密尔顿抑郁量表（HAM-D）评分均显著下降；新型药物组的平均HAM-D降低幅度最大：（17.2，p < 0.001）。所有组的生活质量均有所提高；新型药物组的QoL评分平均提高幅度（19.7，p < 0.01）最高。与SSRIs组（84%）和SNRIs组（82%）相比，新型药物组的副作用发生率同样最低，这提高了依从率（91%）。
结论
新型抗抑郁药物比SSRIs和SNRIs显示出更好的疗效和耐受性，从而提高了生活质量和依从性。这些发现意味着对于那些对传统治疗反应不佳的患者，新型药物可能是一个很好的替代选择。要证实这些结论需要更多长期、多中心的研究。
