米那普仑对比帕罗西汀治疗抑郁症有效性与不良反应的Meta分析

The efficacy and adverse reactions of milnacipran versus paroxetine in treatment of depression:a Meta⁃analysis

目的对比特异性5⁃羟色胺⁃去甲肾上腺素(5⁃HT/NE)再摄取抑制剂米那普仑和选择性5⁃羟色胺(5⁃HT)再摄取抑制剂帕罗西汀治疗抑郁症的有效性与不良反应。方法运用计算机检索网络公共数据库PubMed、CochraneLibrary、Webof Science以及EMBASE,检索时间为从建库至2021年1月1日,纳入米那普仑对比帕罗西汀治疗抑郁症的前瞻性研究,从中提取有效率以及不良反应数据进行荟萃分析。结果在775项检索结果中,筛选出5项前瞻性研究,其中4项纳入荟萃分析,共包含1143名患者。分析结果显示,米那普仑和帕罗西汀2种药物有效率(OR=1.08,95%CI为0.84~1.39,P=0.54)及不良反应(RR=0.96,95%CI为0.89~1.04,P=0.43)比较,差异无统计学意义。结论虽然不良反应率相近,但特异性5⁃HT/NE再摄取抑制剂米那普仑与选择性5⁃HT再摄取抑制剂帕罗西汀相比,未能显著提高抑郁症治疗的有效性。

Objective To compare the efficacy and adverse reactions of milnacipran(an inhibitorthat reuptake of both seroto⁃ninand noradrenaline)versus paroxetine(a selective serotonin reuptake inhibitor)in treatment of depression by Meta⁃analysis.Meth⁃ods Online databases,such as PubMed,Cochrane Library,Web of Science and EMBASE were searched from inception to Jan 1,2021.Prospective studies concerning milnacipran versus paroxetine in treatment of depression were eligible for the study.Data of re⁃sponse rates and adverse events were collected for Meta⁃analysis.Results Of the 775 retrieved papers,5 were selected for prospec⁃tive studies and 4 were included for further Meta⁃analysis,involving 1143 patients.Analysis results indicated that there was no statis⁃tical significance in the efficacy and adverse reactions of milnacipran and paroxetine,when comparisons were made between them(odds ratio=1.08,95%,confidence interval=0.84~1.39,P=0.54)(risk ratio=0.96,95%CI=0.89~1.04,P=0.43).Conclusion Our analysis failed to show that milnacipran was superior to paroxetine in improving responses and toxicities in the depressed patients.