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논문 기본 정보

자료유형
학술저널
저자정보
Sheng Min Wang (The Catholic University) Nak-Young Kim (Keyo Hospital) Hae-Ran Na (The Catholic University of Korea) Hyun Kook Lim (The Catholic University of Korea) Young Sup Woo (The Catholic University of Korea) Chi-Un Pae (The Catholic University of Korea) Won-Myong Bahk (The Catholic University of Korea)
저널정보
대한정신약물학회 Clinical Psychopharmacology and Neuroscience Clinical Psychopharmacology and Neuroscience 제19권 제2호
발행연도
2021.1
수록면
341 - 354 (14page)

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Objective: We performed a meta-analysis of randomized double-blinded placebo controlled trials (DB-RCTs) to investigate efficacy and safety of intranasal esketamine in treating major depressive disorder (MDD) including treatment resistant depression (TRD) and major depression with suicide ideation (MDSI). Methods: Mean change in total scores on Montgomery-Asberg Depression Rating Scale (MADRS) from baseline to different time-points were our primary outcome measure. Secondary efficacy measures included rate of remission of depression and resolution of suicidality. Results: Eight DB-RCTs (seven published and one un-published) covering 1,488 patients with MDD were included. Esketamine more significantly improved MADRS total scores than placebo starting from 2?4 hours after the first administration (standardized mean difference, ?0.41 [95% CI, ?0.58 to ?0.25], p ＜ 0.00001), and this superiority maintained until end of double-blinded period (28 days). Sub-group analysis showed that superior antidepressant effects of esketamine over placebo in TRD and MDSI was observed from 2?4 hours, which was maintained until 28 days. Resolution of suicide in MDSI was also greater for esketamine than for placebo at 2?4 hours (OR of 2.04, 95% CIs, 1.37 to 3.05, p = 0.0005), but two groups did not statistically differ at 24 hours and day 28. Total adverse events (AEs), and other common AEs including dissociation, blood pressure increment, nausea, vertigo, dysgeusia, dizziness, and somnolence were more frequent in esketamine than in placebo group. Conclusion: Esketamine showed rapid antidepressant effects in patients with MDD, including TRD and MDSI. The study also suggested that esketamine might be associated with rapid anti-suicidal effects for patients with MDSI.
#Esketamine #Depression #Treatment resistant depression #Suicide #Meta-analysis.

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참고문헌 (35)

참고문헌 신청
Kessler RC / 2012 / Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States / Int J Methods Psychiatr Res 21:169~184 google schola Chiara Fabbri / 2020 / Genetics of Treatment Outcomes in Major Depressive Disorder: Present and Future / Clinical Psychopharmacology and Neuroscience 18(1):1~9 dbpia Fava M / 2003 / Diagnosis and definition of treatment-resistant depression / Biol Psychiatry 53:649~659 google schola Rush AJ / 2006 / Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps : a STAR*D report / Am J Psychiatry 163:1905~1917 google schola Chiara Fabbri / 2020 / How to Utilize Clinical and Genetic Information for Personalized Treatment of Major Depressive Disorder: Step by Step Strategic Approach / Clinical Psychopharmacology and Neuroscience 18(4):484~492 dbpia

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