抑郁症治疗目标临床治愈.ppt

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**ResultsofthisanalysisconfirmtheresultsofthepreviouspooledanalysisofregistrationtrialsbyThaseandcolleaguesdemonstratingthatmorepatientsachievedremissionofsymptomswithvenlafaxine/venlafaxineXRcomparedwiththestudiedSSRIs.Overallremissionratesat8weeksoftreatmentinapooledanalysisof32of33availablestudies(1studywasexcludedfromthisanalysisbecausetheHAM-Dscalewasnotused)were:venlafaxine/venlafaxineXR,41%(1,364/3,300);SSRIs,35%(1,121/3,236);andplacebo,24%(225/927).Thevenlafaxine-SSRI,venlafaxine-placebo,andSSRI-placebocomparisonsatendpointwereallstatisticallysignificant(P0.001).Theseresultsconfirmpriordatasuggestingthesignificantlygreaterlikelihoodofachievingremissionofdepressionwithadualreuptakeinhibitorsuchasvenlafaxine/venlafaxineXRvs.thesingle-actionSSRIs.Poolingofthisentiredatasetnegatesacommoncriticismoftheoriginalpooledanalysis(i.e.,thatthe8studieswere“cherry-picked”ornotrepresentativeoftheentiredataset).Thisdatasetincludedstudiesthatmettherigidcriteriarequiredforregistrationstudiesaswellassmallerpostmarketingstudiesthatdidnotnecessarilymeetthesecriteria.Thefactthatthesedatacloselycorroboratetheoriginalresultslendsfurthercredibilitytothevalidityoftheinitialpooledanalysis.WillardLB,EntsuahR,DemitrackMA.VenlafaxineandSSRIs:pooledremissionanalysis.Presentedat:AmericanCollegeofNeuropsychopharmacology;December2002;SanJuan,PuertoRico.ThaseME,EntsuahR,RudolphRL.Remissionratesduringtreatmentwithvenlafaxineorselectiveserotoninreuptakeinhibitors.BrJPsychiatry.2001;178:234-241.*从这张图可以更直观的看到,怡诺思治疗第二周的临床治愈率就显著高于SSRI,而第八周时怡诺思的这种优势已经特别显著:高出1/3。**预防复发累计持续预防复发比率,双盲治疗天数剂量文拉法辛**InastudybyPaykeletal.(1995),earlyrelapseoccurredin76%ofpatientswithresidualsymptoms,whichwasmuchhighercomparedtothe25%thosewithoutre

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