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首页> 外文期刊>The journal of clinical psychiatry >Efficacy of bupropion and the selective serotonin reuptake inhibitors in the treatment of major depressive disorder with high levels of anxiety (anxious depression): a pooled analysis of 10 studies.
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Efficacy of bupropion and the selective serotonin reuptake inhibitors in the treatment of major depressive disorder with high levels of anxiety (anxious depression): a pooled analysis of 10 studies.

机译：安非他酮和选择性5-羟色胺再摄取抑制剂治疗严重焦虑症（焦虑抑郁症）的严重抑郁症的疗效：十项研究的汇总分析。

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OBJECTIVE: The goal of this work was to compare the efficacy of the norepinephrine and dopamine reuptake inhibitor bupropion with the selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder with high levels of anxiety (anxious depression). METHOD: Ten double-blind, randomized studies from 1991 through 2006 were combined (N = 2122). Anxious depression was defined as a 17-item Hamilton Rating Scale for Depression (HAM-D-17) anxiety-somatization factor score >or= 7. RESULTS: Among patients with anxious depression (N = 1275), response rates were greater following SSRI than bupropion treatment according to the HAM-D-17 (65.4% vs. 59.4%, p = .03) and the Hamilton Rating Scale for Anxiety (61.5% vs. 54.5%, p = .03). There was also a greater reduction in HAM-D-17 mean +/- SD scores (-14.1 +/- 7.6 vs. -13.2 +/- 7.9, p = .03) and a trend toward statistical significance for a greater reduction in HAM-A mean +/- SD scores (-10.5 +/- 7.4 vs. -9.6 +/- 7.6, p = .05) in favor of SSRI treatment among patients with anxious depression. There was no statistically significant difference in efficacy between bupropion and the SSRIs among patients with moderate/low levels of anxiety. CONCLUSIONS: There appears to be a modest advantage for the SSRIs compared to bupropion in the treatment of anxious depression (6% difference in response rates). Using the number-needed-to-treat (NNT) statistic as 1 indicator of clinical significance, nearly 17 patients would need to be treated with an SSRI than with bupropion in order to obtain 1 additional responder. This difference falls well above the limit of NNT = 10, which was suggested by the United Kingdom's National Institute of Clinical Excellence. Nevertheless, the present work is of theoretical interest because it provides preliminary evidence suggesting a central role for serotonin in the regulation of symptoms of negative affect such as anxiety.
机译：目的：本研究的目的是比较去甲肾上腺素和多巴胺再摄取抑制剂安非他酮与选择性5-羟色胺再摄取抑制剂（SSRIs）在治疗重度焦虑症（焦虑症）中的疗效。方法：将1991年至2006年的十项双盲，随机研究合并在一起（N = 2122）。焦虑抑郁症定义为17个项的抑郁症汉密尔顿抑郁量表（HAM-D-17）焦虑-躯体化因子得分>或=7。结果：在焦虑抑郁症患者（N = 1275）中，SSRI后的缓解率更高根据HAM-D-17（65.4％vs. 59.4％，p = .03）和汉密尔顿焦虑量表（61.5％vs. 54.5％，p = .03）进行安非他酮治疗。 HAM-D-17的平均+/- SD得分也有较大降低（-14.1 +/- 7.6与-13.2 +/- 7.9，p = .03），并且具有统计学上的显着趋势，即降低HAM-A的平均+/- SD评分（-10.5 +/- 7.4对-9.6 +/- 7.6，p = 0.05）支持焦虑抑郁患者的SSRI治疗。在中度/低度焦虑症患者中，安非他酮和SSRIs的疗效无统计学差异。结论：与安非他酮相比，SSRIs在焦虑抑郁症治疗中似乎具有中等优势（缓解率相差6％）。使用需要治疗的数量（NNT）统计数据作为临床意义的1个指标，将需要用SSRI而非安非他酮治疗近17位患者，以获得1位额外的反应者。这种差异远高于英国国家临床卓越研究所建议的NNT = 10的限制。尽管如此，当前的工作还是具有理论意义的，因为它提供了初步的证据，表明5-羟色胺在调节诸如焦虑之类的负面影响的症状中起着核心作用。

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