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Comparación del comienzo del efecto de los antidepresivos: consideraciones pragmáticas sobre los métodos y los puntos finales

Published online by Cambridge University Press:  12 May 2020

D. Hackett
D. Hackett*
Affiliation:
Wyeth-Ayerst Research, European CR&D, Le Wilson II, 80 ave du Président Wilson, Puteaux, 92031Paris La Défense Cedex, Francia
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Resumen

No existe una definición aceptada de lo que constituye el comienzo del efecto antidepresivo, y esto limita la evaluación de la validez de muchos informes comparativos. Para clarificar la naturaleza de los métodos de comparación necesarios, se propone separar conceptualmente dos preguntas de investigación distintas: 1) ¿cuándo comienzan a actuar clínicamente los medicamentos antidepresivos? y 2) ¿producen todos los medicamentos antidepresivos el alivio de los síntomas en los pacientes dentro de un período de tiempo similar? Se puede hacer también una distinción metodológica en función de si el comienzo del efecto de un antidepresivo se evalúa como si tuviera una cualidad absoluta (“rápido”) o como si fuera rápido en relación con otros tratamientos (“más rápido”). La elección de objetivo ayudará a definir el enfoque metodológico, la aplicabilidad de los resultados y las dificultades a las que es preciso dirigirse. Describir un antidepresivo como una sustancia que muestra un comienzo “rápido” o “más rápido” de la respuesta requiere que se trate de definir en cualquier caso (en términos que se puedan generalizar) la naturaleza de la comparación (¿más rápido que qué?), la naturaleza del efecto (¿más rápido para hacer qué?) y la población en la que este efecto se puede esperar (más rápido en quién?). Se revisan algunos detalles de los enfoques metodológicos y se hacen propuestas para diseños de estudio.

Keywords

metodología de los ensayos clínicosantidepresivoscomienzo de la acción
Type
Research Article
Information
European Psychiatry (Ed. Española) , Volume 5 , Issue 7 , October 1998 , pp. 420 - 428
Copyright
Copyright © European Psychiatric Association 1998

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Footnotes

Hackett D. Comparing onset of effect of antidepressants: pragmatic considerations on methods and end-points. Eur Psychiatry 1998; 13: 117-123.

References

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