METHODS: We conducted a systematic review of the Cochrane Library, PubMed, CINHAL, and ClinicalTrials.gov databases until January 1, 2023. Double-blind, randomized, placebo-controlled trials evaluating aripiprazole, brexpiprazole, and cariprazine for treatment-resistant depression were included. A random-effect dose-response model-based network meta-analysis was conducted. This study was registered in PROSPERO (CRD42023393035).
RESULTS: The maximum effective doses were 5.5 mg for aripiprazole, 1.6 mg for brexpiprazole, and 1.5 mg for cariprazine, respectively. Although all doses of the 3 drugs were significantly more effective than placebo, aripiprazole ranging from 5.5 to 12.5 mg was significantly more effective than brexpiprazole 0.5 mg and cariprazine ranging from 0.5 to 1 mg. Moreover, aripiprazole ranging from 7.5 to 12.5 mg was significantly more effective than all doses of cariprazine. In addition, brexpiprazole ranging from 1 to 3 mg was significantly more effective than cariprazine 0.5 mg and brexpiprazole ranging from 1.6 to 2.5 mg was significantly superior to cariprazine 1 mg. There were no doses at which brexpiprazole overcame aripiprazole, and cariprazine overcame aripiprazole or brexpiprazole.
CONCLUSIONS: Aripiprazole, brexpiprazole, and cariprazine may be effective in treatment-resistant depression in that order, with the maximum effective doses at 5.5 mg, 1.6 mg, and 1.5 mg, respectively.
方法:我们对Cochrane图书馆进行了系统评价,PubMed,CINHAL,和ClinicalTrials.gov数据库,直到2023年1月1日。双盲,随机化,安慰剂对照试验评估阿立哌唑,布立哌唑,包括卡利拉嗪治疗难治性抑郁症。进行了基于随机效应剂量反应模型的网络荟萃分析。本研究在PROSPERO(CRD42023393035)注册。
结果:阿立哌唑的最大有效剂量为5.5mg,1.6毫克用于布列哌唑,卡利拉嗪1.5毫克,分别。尽管3种药物的所有剂量都比安慰剂有效,5.5~12.5mg的阿立哌唑比0.5mg和0.5~1mg的卡利拉嗪更有效.此外,7.5~12.5mg的阿立哌唑比所有剂量的卡利拉嗪更有效.此外,1~3mg的巴立哌唑明显优于0.5mg的卡利拉嗪,1.6~2.5mg的巴立哌唑明显优于1mg的卡利拉嗪.没有任何剂量的巴立哌唑可以战胜阿立哌唑,卡利拉嗪战胜了阿立哌唑或布立哌唑。
结论:阿立哌唑,布立哌唑,卡利拉嗪可能对治疗难治性抑郁症有效,最大有效剂量为5.5毫克,1.6mg,和1.5毫克,分别。