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首页> 外文期刊>The journal of clinical psychiatry >Is there a delay in the antidepressant effect? A meta-analysis.
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Is there a delay in the antidepressant effect? A meta-analysis.

机译：抗抑郁药的作用有延迟吗？荟萃分析。

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OBJECTIVES: It has long been thought that there is a delay of several weeks before a true antidepressant effect occurs, although this theory has increasingly come into question. The goals of this meta-analysis were to determine whether significant drug-placebo separation occurs during the first 2 weeks of treatment and to ascertain whether the timing of response to antidepressant medication and placebo is distinct. DATA SOURCES: Seventy-six double-blind, placebo-controlled trials conducted between 1981 and 2000, included in a recently published meta-analysis that evaluated placebo response rates in depressed outpatients, were reviewed. In addition, each issue of 6 psychiatric journals from January 1992 through December 2001 was reviewed. STUDY SELECTION: Forty-seven studies that evaluated antidepressant medications with established efficacy, performed weekly or biweekly (every other week) evaluations, and presented the time course of improvement as measured by the Hamilton Rating Scale for Depression were included in our meta-analysis. DATA SYNTHESIS: The time course of improvement on active medication and placebo was nearly identical, as 60.2% and 61.6% of the improvement that occurred on active medication and placebo, respectively, took place during the first 2 weeks of treatment. Drug-placebo differences were not only present but were most pronounced during the first 2 weeks of treatment and diminished in a stepwise fashion thereafter. A series of subanalyses confirmed that this early drug-placebo separation was clinically observable and represented a true drug effect. CONCLUSION: These results challenge the notion that a delay exists before a true antidepressant effect occurs.
机译：目的：长期以来人们一直认为，真正的抗抑郁作用会延迟数周才能出现，尽管该理论受到越来越多的质疑。这项荟萃分析的目的是确定在治疗的前2周内是否发生了明显的药物-安慰剂分离，并确定对抗抑郁药和安慰剂的反应时间是否不同。资料来源：回顾了1981年至2000年之间进行的76项双盲，安慰剂对照试验，该试验包括在最近发表的评估抑郁症门诊患者安慰剂反应率的荟萃分析中。此外，还审查了从1992年1月到2001年12月的每期6种精神病学期刊。研究选择：我们的荟萃分析包括47项评估抗抑郁药物是否有效的研究，每周或每两周（每隔一周一次）进行评估，并提出汉密尔顿抑郁量表评估的改善时间。数据综合：活性药物和安慰剂改善的时间过程几乎相同，因为在治疗的前两周分别发生了活性药物和安慰剂改善的60.2％和61.6％。药物-安慰剂的差异不仅存在，而且在治疗的前两周最为明显，此后逐步降低。一系列的子分析证实了这种早期的药物-安慰剂分离在临床上是可观察到的，并且代表了真正的药物作用。结论：这些结果挑战了真正的抗抑郁作用出现之前存在延迟的观念。

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