Gao Ren-Xian, Zhang Xiao-Na, Zhu Peng
Department of Emergency, Wenzhou People's Hospital (The Third Affiliated Hospital of Shanghai University), Wenzhou 325000, Zhejiang Province, China.
Department of Orthopedics, Wenzhou Central Hospital, Wenzhou 325000, Zhejiang Province, China.
World J Psychiatry. 2025 Mar 19;15(3):100103. doi: 10.5498/wjp.v15.i3.100103.
Traumatic brain injury (TBI) poses a considerable risk to human health. After TBI, individuals are susceptible to a range of psychiatric disorders, with depression being a primary complication. Selective serotonin reuptake inhibitors (SSRIs) are frequently used in the treatment of depression; however, their efficacy in addressing major depressive disorder (MDD) in adults following TBI remains uncertain.
To investigate the efficacy of SSRIs in the treatment of MDD after TBI.
A comprehensive search across multiple databases was conducted following the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, encompassing studies published until May 2024. This review focused on studies that examined the efficacy of SSRIs in the treatment of MDD following TBI. Studies were assessed based sample size, treatment duration, treatment methodologies, severity of brain injury, assessment techniques, and drug response. A random-effects model was used to derive the summary effect size.
Eight studies compared the reduction in depression scores in patients with MDD after TBI and SSRI treatment. The eight studies did not exhibit heterogeneity ( = 38%). The depression score for MDD after TBI in the SSRI group decreased more than that in the control group [odds ratio (OR) 1.68, 95%CI: 1.09-2.58, = 0.02]. The adverse reactions after treatment included diarrhea, dizziness, dry mouth, nausea, or vomiting. There was no difference in the incidence of adverse reactions after treatment between the two groups (OR 1.16, 95%CI: 0.78-1.73, = 0.46]. These studies did not show significant heterogeneity ( = 44%).
SSRIs may be effective in treating patients with MDD after TBI. Adequately powered, randomized, controlled trials are required to confirm these findings.
创伤性脑损伤（TBI）对人类健康构成重大风险。TBI后，个体易患一系列精神疾病，抑郁症是主要并发症之一。选择性5-羟色胺再摄取抑制剂（SSRIs）常用于治疗抑郁症；然而，其对TBI后成年患者重度抑郁症（MDD）的疗效仍不确定。
研究SSRIs治疗TBI后MDD的疗效。
按照系统评价和Meta分析的首选报告项目声明中概述的指南，对多个数据库进行全面检索，涵盖截至2024年5月发表的研究。本综述重点关注研究SSRIs治疗TBI后MDD疗效的研究。根据样本量、治疗持续时间、治疗方法、脑损伤严重程度、评估技术和药物反应对研究进行评估。采用随机效应模型得出汇总效应量。
八项研究比较了TBI后MDD患者接受SSRI治疗后抑郁评分的降低情况。这八项研究未表现出异质性（I² = 38%）。SSRI组TBI后MDD的抑郁评分下降幅度大于对照组[优势比（OR）1.68，95%置信区间：1.09 - 2.58，P = 0.02]。治疗后的不良反应包括腹泻、头晕、口干、恶心或呕吐。两组治疗后不良反应发生率无差异（OR 1.16，95%置信区间：0.78 - 1.73，P = 0.46）。这些研究未显示出显著异质性（I² = 44%）。
SSRIs可能对治疗TBI后MDD患者有效。需要开展有足够样本量的随机对照试验来证实这些发现。
