주요 정신과적 질환에서 Duloxetine 단독요법과 다른 항우울제와의 병합요법의 효과 비교 : 단기간, 후향적 연구 (Effectiveness of Duloxetine Monotherapy Compared to Combination Therapy with Other Antidepressants in Patients with Major Psychiatric Disorders : A Short-Term, Retrospective Study)

서지정보

· 발행기관 : 대한생물치료정신의학회
· 수록지 정보 : 생물치료정신의학 / 21권 / 3호 / 181 ~ 191페이지
· 저자명 : 정성윤, 구본훈, 이준엽, 최중현, 천은진

초록

Background：Duloxetine is an antidepressant that effects a serotonergic and noradrenergic neurotransmitter, and a useful agent in the treatment of the patients with depressive or anxiety or somatoform disorders. According to the recently reported study results, combination therapy with other antidepressants in the treatment of patients with major depressive disorder did not show a superior efficacy but might have a greater risk of producing adverse events. But, combination strategy is still most commonly used to make clinical improvement in clinical practice.
Objectives：The purpose of this study was to compare duloxetine monotherapy to combination therapy with other antidepressants in patients with depressive, anxiety or somatoform disorders.
Methods：An 8-week, naturalistic, retrospective, multi-center study in outpatients with depressive, anxiety or somatoform disorders was undertaken. A total of 174 patients that had been taken with duloxetine were enrolled in this study from July, 2009 to June, 2014 through 3 centers. We compared the mean changes of the Clinical Global Impression Scale-Severity(CGI-S) as primary efficacy measure and the discontinuation rate and adverse effect as secondary measures between duloxetine monotherapy group(n=71) and combination therapy with other antidepressants group (n=103) at baseline, 1, 2, 4, 8 week.
Results：There were no significant differences across the demographic characteristics between duloxetine monotherapy group and combination therapy group. There was a statistically greater improvement on the CGI-S in the combination group compared with the monotherapy group in patients with depressive(p=0.04) and anxiety disorders(p=0.02). There were no significant difference in the discontinuation rate and adverse event between duloxetine monotherapy group and combination therapy group.
Conclusion：Despite the limitation of our retrospective study, this results suggest that duloxetine combination therapy with other antidepressants compared to monotherapy would have a superior efficacy and similar tolerability in the treatment of patients with depressive and anxiety disorders. Adequately powered, well-controlled clinical trials are strongly warranted to confirm our findings due to methodological shortcomings.

영어초록

Background：Duloxetine is an antidepressant that effects a serotonergic and noradrenergic neurotransmitter, and a useful agent in the treatment of the patients with depressive or anxiety or somatoform disorders. According to the recently reported study results, combination therapy with other antidepressants in the treatment of patients with major depressive disorder did not show a superior efficacy but might have a greater risk of producing adverse events. But, combination strategy is still most commonly used to make clinical improvement in clinical practice.
Objectives：The purpose of this study was to compare duloxetine monotherapy to combination therapy with other antidepressants in patients with depressive, anxiety or somatoform disorders.
Methods：An 8-week, naturalistic, retrospective, multi-center study in outpatients with depressive, anxiety or somatoform disorders was undertaken. A total of 174 patients that had been taken with duloxetine were enrolled in this study from July, 2009 to June, 2014 through 3 centers. We compared the mean changes of the Clinical Global Impression Scale-Severity(CGI-S) as primary efficacy measure and the discontinuation rate and adverse effect as secondary measures between duloxetine monotherapy group(n=71) and combination therapy with other antidepressants group (n=103) at baseline, 1, 2, 4, 8 week.
Results：There were no significant differences across the demographic characteristics between duloxetine monotherapy group and combination therapy group. There was a statistically greater improvement on the CGI-S in the combination group compared with the monotherapy group in patients with depressive(p=0.04) and anxiety disorders(p=0.02). There were no significant difference in the discontinuation rate and adverse event between duloxetine monotherapy group and combination therapy group.
Conclusion：Despite the limitation of our retrospective study, this results suggest that duloxetine combination therapy with other antidepressants compared to monotherapy would have a superior efficacy and similar tolerability in the treatment of patients with depressive and anxiety disorders. Adequately powered, well-controlled clinical trials are strongly warranted to confirm our findings due to methodological shortcomings.

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