Efficacy of orexin antagonists for the management of major depressive disorder: A systematic review of randomized clinical trials.

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Journal of affective disorders Pub Date : 2025-03-01 Epub Date: 2024-12-04 DOI:10.1016/j.jad.2024.12.008
Shakila Meshkat, Angela T H Kwan, Gia Han Le, Sabrina Wong, Kayla M Teopiz, Larry Wang, Joshua D Rosenblat, Taeho Greg Rhee, Bing Cao, Roger S McIntyre
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Abstract

Orexin receptor antagonists are a group of medications primarily developed to treat insomnia. Preliminary studies support their efficacy in the treatment of depression. In this systematic review, we aim to evaluate the efficacy of orexin receptor antagonists for the treatment of major depressive disorder (MDD). Electronic databases were searched from inception to February 2024 to find relevant studies. Original studies in English that evaluated efficacy of orexin receptor antagonists were included. A total of five randomized clinical trials involving 498 participants were included. Seltorexant (20 mg) significantly decreased depression scores when compared to placebo, as measured by the Hamilton Depression Rating Scale (HDRS). In patients with inadequate responses to antidepressants, seltorexant (20 mg) also showed improvement in Montgomery-Ǻsberg Depression Rating Scale (MADRS) total scores compared to placebo. However, filorexant did not exhibit a significant difference in MADRS total scores compared to placebo. A separate study on seltorexant (40 mg) for MDD patients resulted in a non-significant decrease in depressive symptoms compared to placebo, as measured by the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR). Taken together, these findings highlight the potential of orexin receptor antagonists, particularly seltorexant, as a novel avenue for managing depressive symptoms in MDD. Further research is warranted to better understand their role in depression treatment and their safety profile.

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食欲素拮抗剂治疗重度抑郁症的疗效:随机临床试验的系统综述。
食欲素受体拮抗剂是一组主要用于治疗失眠的药物。初步研究支持其治疗抑郁症的功效。在这篇系统综述中,我们旨在评估食欲素受体拮抗剂治疗重度抑郁症(MDD)的疗效。从成立到2024年2月检索电子数据库查找相关研究。评估食欲素受体拮抗剂疗效的英文原始研究被纳入。共纳入5项随机临床试验,涉及498名受试者。根据汉密尔顿抑郁评定量表(HDRS)测量,Seltorexant(20 mg)与安慰剂相比显著降低抑郁评分。在抗抑郁药反应不足的患者中,seltorexant(20 mg)与安慰剂相比,也显示出Montgomery-Ǻsberg抑郁评定量表(MADRS)总分的改善。然而,与安慰剂相比,filorexant在MADRS总分上没有显着差异。另一项关于重度抑郁症患者服用seltorexant(40 mg)的独立研究显示,与安慰剂相比,抑郁症状没有显著减少,这是通过抑郁症状自我报告快速清单(QIDS-SR)来测量的。综上所述,食欲素受体拮抗剂,特别是seltorexant,作为治疗重度抑郁症抑郁症状的新途径的潜力。为了更好地了解它们在抑郁症治疗中的作用和安全性,需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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