荟萃分析
奥氮平
重性抑郁障碍
随机对照试验
医学
安慰剂
氟西汀
萧条(经济学)
联合疗法
精神科
严格标准化平均差
内科学
心理学
精神分裂症(面向对象编程)
心情
替代医学
宏观经济学
病理
经济
受体
血清素
作者
Saeed Farooq,Surendra Prasad Singh
标识
DOI:10.1177/0269881114541016
摘要
Despite highly prevalent use of drug combinations in psychiatry, combination products are not commonly available. We aimed to systematically review the evidence for the use and efficacy of combination products in the practice of psychiatry. Systematic search of major data bases yielded nine double-blind randomized controlled trials, which generated 15 comparisons of combination products against a single therapeutic agent, that included a placebo. All these studies included 2827 participants: 976 in their combination products arms and 1851 patients in the comparator arms. The number of combination products were identified, but all except two studies tested only one combination drug (e.g. olanzapine and fluoxetine (OFC)). All combined formulations were significantly superior to a single agent, with standardized mean distance (SMD) of − 0.29 (confidence interval (CI) = − 0.43, − 0 .14; p < 0.001) in improving depression. In the subgroup analysis, the OFC combination was significantly superior to a single therapeutic agent for bipolar depression (SMD = − 0.32; CI = − 0.45, − 0.19; p < 0.001) and for treatment-resistant depression (SMD = − 0.29; CI = − 0.49, − 0.08; p < 0.005), but not for borderline personality nor major depressive disorder (MDD). The evidence in general medicine suggests that combination products can offer significant advantage in improving efficacy and treatment adherence; but in psychiatry, research and development in fixed-dose combinations has been limited.
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