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比较研究
. 2010年8月; 167(8):934-41。
DOI:10.1176 / appi.ajp.2010.09060880。 Epub 2010 May 17.

随着逐渐停止抗抑郁药的疾病风险

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比较研究

随着逐渐停止抗抑郁药的疾病风险

Ross J Baldessariniet al. am j精神病学. 2010年8月.

抽象的

Objective:Rapid discontinuation of some psychotropic medications is followed by discontinuation symptoms as well as an increased risk of early illness recurrence. Recurrence occurs earlier after rapid than after gradual discontinuation with lithium and antipsychotics. The authors compared illness recurrence after rapid versus gradual discontinuation of antidepressants.

方法:作者将患者进行了398例患者的经常性重大抑郁症(n = 224),恐慌症(n = 75),双极II疾病(n = 62),或双极I紊乱(n = 37)。三分之二是女性,平均年龄为42岁,患者用抗抑郁剂治疗均为8.5个月。临床上停止抗抑郁药,迅速(超过1-7天; n = 188)或逐渐(超过14天以上; n = 210),平均随访时间为2.8岁;在分析中排除了在停止时生病的患者。作者使用生存分析和COX多变量建模比较了第一次新生事件的潜水时间。

结果:The latency to first illness with rapid discontinuation was 0.4 times that with gradual discontinuation, and the latency after rapid discontinuation was one-fourth the estimated average previous interepisode interval in the same patients. The effect was similar across antidepressant classes and across years; the pace of discontinuation had less effect with drugs of prolonged half-life. The effect also varied by diagnosis (bipolar I > or = panic > bipolar II > or = major depressive disorder) but not by episodes per year, duration of index illness, use of concomitant treatment, or antidepressant dose or duration.

结论:抑郁症或恐慌的复发风险比逐渐停止抗抑郁药后的快速较短。这些调查结果对临床管理和临床试验的设计和解释具有影响。

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