Mittmann N, Herrmann N, Einarson T R, Busto U E, Lanctôt K L, Liu B A, Shulman K I, Silver I L, Narango C A, Shear N H
Division of Clinical Pharmacology, Sunnybrook Health Science Centre, University of Toronto, Canada.
J Affect Disord. 1997 Dec;46(3):191-217. doi: 10.1016/s0165-0327(97)00107-9.
To determine the efficacy, safety and tolerability of antidepressants in depressed elderly patients.
Search for randomized controlled double-blind studies evaluating atypical antidepressants (ATYPs), reversible inhibitors of monoamine oxidase-A, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants in moderate/severe depressed patients > or = 60 years for > or = four weeks. The random effects model (single-arm; comparative) was used to aggregate efficacy, safety and dropout.
No difference in single-arm aggregation of outcomes for four antidepressant classes. Comparative analyses showed no statistical difference between outcomes, except SSRIs had a higher response rate than ATYPs.
Elderly show no differences in antidepressant class outcomes.
Heterogeneity and lack of power.
There is little advantage for antidepressant classes over another in the aged.
确定抗抑郁药在老年抑郁症患者中的疗效、安全性和耐受性。
检索评估非典型抗抑郁药（ATYPs）、单胺氧化酶A可逆抑制剂、选择性5-羟色胺再摄取抑制剂（SSRIs）和三环类抗抑郁药用于60岁及以上中度/重度抑郁症患者且疗程≥四周的随机对照双盲研究。采用随机效应模型（单臂；比较性）汇总疗效、安全性和脱落情况。
四类抗抑郁药在单臂汇总结果方面无差异。比较分析显示各结果之间无统计学差异，除了SSRIs的有效率高于ATYPs。
老年人在抗抑郁药类别结果方面无差异。
异质性和效能不足。
在老年人中，各类抗抑郁药相比其他药物优势不大。
