Lancet psychiat:奥氮平对严重程度不同的急性躁狂症的治疗效果。

2017-09-20 qinqiyun MedSci原创

抗精神病药物在急性躁狂症患者初始严重程度的具体疗效尚不清楚。现Myrto T Samara及其同事对急性躁狂症患者的初始严重程度对奥氮平的疗效的影响进行研究。

抗精神病药物在急性躁狂症患者初始严重程度的具体疗效尚不清楚。现Myrto T Samara及其同事对急性躁狂症患者的初始严重程度对奥氮平的疗效的影响进行研究。

研究人员对比较奥氮平和安慰剂的双盲随机对照试验的数据进行Meta分析。从ClinicalStudyRequest.com数据库中检索2016年2月2日前发表的文献。纳入的患者是与I型双向情感障碍相关的躁狂症患者。对初始严重程度和治疗效果之间的关联进行评估(根据青少年躁狂量表[YMRS;0-60])。

筛选到33篇报道,其中5篇(15%)符合要求,共包含939位患者(552位接受奥氮平、387位接受安慰剂)。初始严重程度和治疗效果的关联显著(0.22,95%CI 0.05-0.39;p=0.013)。初始程度越严重,奥氮平和安慰剂的疗效差异的级别就越大。奥氮平组和安慰剂组的平均YMRS评分于3周时均下降,但奥氮平组比安慰剂组评分下降更多:初始评分20-25分的患者(9.26 vs 6.70;效应值0.35,95% CI 0.11-0.60)、25-35分的患者(14.25 vs 9.51;0.58,0.34-0.86)、35-60分的患者(21.72 vs 13.71;0.70,0.31-1.23)。

奥氮平的优点是对于急性躁狂症不同的严重程度均可发挥治疗作用。用奥氮平治疗,症状较轻的患者比症状严重的患者获益较少,但面临的相同的副反应的风险。因此,临床医生和患者均应仔细考虑长期应用时奥氮平的效益风险比及其额外的预防复发的效果。其他抗精神病的药物是否有相似的情况,需要继续科研探索。

原始出处:

Myrto T Samara,et al.Initial symptom severity of bipolar I disorder and the efficacy of olanzapine: a meta-analysis of individual participant data from five placebo-controlled studies.The Lancet Psychiatry.September 19,2017.http://dx.doi.org/10.1016/S2215-0366(17)30331-0

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    2018-05-08 wgx316
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    2018-04-08 howi
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    2017-09-23 138****9420

    谢谢分享

    0

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    2017-09-21 sunfeifeiyang

    对重型急性躁狂更好

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1894000, encodeId=535118940004f, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Thu Dec 28 12:46:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705733, encodeId=b32b1e0573353, content=<a href='/topic/show?id=380f931834c' target=_blank style='color:#2F92EE;'>#躁狂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93183, encryptionId=380f931834c, topicName=躁狂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c31043182, createdName=wgx316, createdTime=Tue May 08 18:46:00 CST 2018, time=2018-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829209, encodeId=d99f1829209de, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Apr 08 21:46:00 CST 2018, time=2018-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246850, encodeId=46292468507e, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/03/4d0fbed0ef4c156dae0e75d85c337b77.jpg, createdBy=074d2111966, createdName=138****9420, createdTime=Sat Sep 23 07:45:25 CST 2017, time=2017-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246229, encodeId=b3cf24622962, content=对重型急性躁狂更好, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Thu Sep 21 07:10:50 CST 2017, time=2017-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245984, encodeId=079c245984de, content=谢谢分享. , beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Sep 20 11:21:03 CST 2017, time=2017-09-20, status=1, ipAttribution=)]
    2017-09-20 doctorJiangchao

    谢谢分享.

    0

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