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首页> 外文期刊>The British journal of psychiatry : >Dose escalation for insufficient response to standard-dose selective serotonin reuptake inhibitors in major depressive disorder
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Dose escalation for insufficient response to standard-dose selective serotonin reuptake inhibitors in major depressive disorder

机译：严重的抑郁症患者对标准剂量选择性5-羟色胺再摄取抑制剂的反应不足，剂量逐步增加

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Background Although selective serotonin reuptake inhibitors (SSRIs) are frequently used for major depressive disorder, only 50a€“60% of patients respond to a standard dose. For non-responders, dose escalation is often applied. Aim To systematically review the evidence for dose escalation of SSRIs. Method A systematic literature search in MEDLINE, EMBASE, CINAHL and PsycInfo was performed. Randomised controlled trials and meta-analyses investigating dose escalation of SSRIs were identified. Relevant articles were retrieved and critically appraised. Results were summarised in an evidence table. Pooling was not justified because of heterogeneity of the identified studies. Results Eighttrue dose-escalation studies and three meta-analyses were identified. The available data provided no unequivocal base fordose escalation. Dose escalation before 4 weeks of treatment at a standard dose appeared to be ineffective. Conclusions Dose escalation of SSRIs is equivocally supported by evidence of randomised controlled trials; methodological difficulties in the studies may account for this lack of evidence.
机译：背景技术尽管选择性5-羟色胺再摄取抑制剂（SSRIs）通常用于重度抑郁症，但只有50％至60％的患者对标准剂量有反应。对于无反应者，经常应用剂量递增。目的系统地回顾SSRIs剂量增加的证据。方法对MEDLINE，EMBASE，CINAHL和PsycInfo进行系统的文献检索。确定了随机对照试验和研究SSRI剂量升高的荟萃分析。检索了相关文章并对其进行了严格评估。结果汇总在证据表中。由于所确定研究的异质性，合并不合理。结果确定了八项真正的剂量递增研究和三项荟萃分析。现有数据没有明确的剂量递增基础。以标准剂量治疗4周之前，剂量递增似乎无效。结论随机对照试验的证据清楚地表明了SSRIs剂量的增加。研究中方法上的困难可能是缺乏证据的原因。

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