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BMJ:抗抑郁药物的使用与自杀风险

2015-02-20 Mechront MedSci原创

抑郁症病人中有很高的自杀率,而对其治疗的关键问题之一是减少自杀率。目前临床上抗抑郁药物主要为三类:三环类抗抑郁药物、选择性5-羟色胺再摄取抑制剂SSRI、其他抗抑郁药物。Carol Coupland等人进行了一项队列研究,以探究抑郁人群中,不同抗抑郁药物的使用与自杀和尝试自杀或自我伤害发生率的联系。该研究纳入了2000-01-01到2011-06-31期间第一次诊断为抑郁症的患者,共23

抑郁症病人中有很高的自杀率,而对其治疗的关键问题之一是减少自杀率。目前临床上抗抑郁药物主要为三类:三环类抗抑郁药物、选择性5-羟色胺再摄取抑制剂SSRI、其他抗抑郁药物。Carol Coupland等人进行了一项队列研究,以探究抑郁人群中,不同抗抑郁药物的使用与自杀和尝试自杀或自我伤害发生率的联系。该研究纳入了2000-01-01到2011-06-31期间第一次诊断为抑郁症的患者,共238,963名,年龄范围20-64岁,研究者们最长随访其到2012-08-01。研究结果显示,87.7%(n=209,476)的患者接受了至少一次的抗抑郁药物处方。治疗持续时间中位数为221天(四分位范围 79-590天)。在第一个5年随访中,198例自杀,5243例尝试自杀或自身伤害。治疗期间,三环类抗抑郁药物相比SSRI对自杀风险没有统计学差异(aHR 0.84,95%CI 0.47-1.50);其他类别抗抑郁药物使用时,自杀风险显著增加(aHR 2.64,95%CI 1.74-3.99)。米氮平与西酞普兰相比,其明显增加自杀风险(aHR&n

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    2016-01-31 wetgdt
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    2015-11-15 柳叶一刀
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