Антипсихотическая аугментация и монотерапия при шизофрении: систематический обзор, мета-анализ и анализ методом метарегрессии
Всемирная психиатрия. №1 2017
Антипсихотическая аугментация и монотерапия при шизофрении: систематический обзор, мета-анализ и анализ методом метарегрессии
Britta Galling1,2,3, Alexandra Roldán4, Katsuhiko Hagi2,5, Liz Rietschel6, Frozan Walyzada2, Wei Zheng7, Xiao‐Lan Cao8, Yu Tao Xiang9, Mathias Zink10, John M. Kane2,3,11,12, Jimmi Nielsen13,14, Stefan Leucht15 and Christoph U. Correll2,3,11,12
1Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany 2Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA 3Hofstra Northwell School of Medicine, Hempstead, NY, USA 4Department of Psychiatry, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creui Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain 5Sumitomo Dainippon Pharma Co., Tokyo, Japan 6University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland 7Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
Стр. 77-89
2717 просмотров
Опубликовано: 1 февраля 2017
Аннотация / Abstract
Вопрос об одновременном назначении нескольких антипсихотиков является спорным, поскольку эта процедура довольно распространенная и затратная, а эффективность и безопасность ее применения не доказаны. Мы осуществили систематический информационный поиск по данному вопросу, а также наблюдали за случайными эффектами в мета-анализе рандомизированных исследований, в процессе которого сравнивались лечение шизофрении при помощи нескольких нейролептиков и продолжающуюся антипсихотическую монотерапию. Главными ожидаемыми результатами были абсолютное отсутствие симптоматики, а также развитие ответа на терапию. Касаясь вопроса о полном исчезновении симптоматики заболевания, следует отметить, что в результате антипсихотической аугментации эта цель была достигнута быстрее, чем при монотерапии (16 исследований, N = 694, стандартизированная разность средних SMD= -0,53, 95% ДИ: от-0,87 до -0.19, p=0.002). Однако, этот результат наблюдался при проведении открытых и сомнительных (малодостоверных) исследований (в обоих p
Вопрос об одновременном назначении нескольких антипсихотиков является спорным, поскольку эта процедура довольно распространенная и затратная, а эффективность и безопасность ее применения не доказаны. Мы осуществили систематический информационный поиск по данному вопросу, а также наблюдали за случайными эффектами в мета-анализе рандомизированных исследований, в процессе которого сравнивались лечение шизофрении при помощи нескольких нейролептиков и продолжающуюся антипсихотическую монотерапию. Главными ожидаемыми результатами были абсолютное отсутствие симптоматики, а также развитие ответа на терапию. Касаясь вопроса о полном исчезновении симптоматики заболевания, следует отметить, что в результате антипсихотической аугментации эта цель была достигнута быстрее, чем при монотерапии (16 исследова...
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