文拉法辛预防前庭偏头痛的有效性和安全性

Alana Asciutti Victorino, Fernando Veiga Angélico Júnior, Paula Ribeiro Lopes Almeida, Priscila Bogar, Osmar Clayton Person
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摘要

目的:评价文拉法辛治疗前庭偏头痛(VM)的疗效和安全性。方法:这是一项随机临床试验的系统综述。检索了以下数据库:PUBMED(1966-2021)、EMBASE(1974-2021)和CENTRAL (Cochrane Library-2021)。调查没有地域和时间限制。数据提取和研究质量评估由两名独立研究人员进行。结果:检索策略确定了47项研究,其中2项纳入本综述,因为它们符合纳入和排除标准。两项研究都评估了文拉法辛治疗前庭偏头痛的疗效,并将结果与其他药物进行了比较。第一项研究(2017年)比较了文拉法辛与氟桂利嗪和丙戊酸的疗效,第二项研究(2015年)比较了文拉法辛与心得安的疗效。所有评估组均显示前庭症状改善,但只有接受文拉法辛治疗的组在情绪DHI(头晕障碍量表)评分和抑郁症状改善方面表现出显著变化。结论:虽然文拉法辛似乎有很好的结果,但目前缺乏研究来评估该药物治疗前庭偏头痛的有效性和安全性。证据相当有限,研究和评估的患者数量减少,建议进行新的高质量随机临床试验来阐明这一问题。
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Eficácia e segurança da Venlafaxina para prevenção de migrânea vestibular
OBJECTIVE: To evaluate the efficacy and safety of Venlafaxine for the control of vestibular migraine (VM). METHODS: This is a systematic review of randomized clinical trials. The following databases were searched: PUBMED (1966-2021), EMBASE (1974-2021) and CENTRAL (Cochrane Library-2021). There was no geographic and period limitation in the survey. Data extraction and study quality assessment were carried out by two independent researchers. RESULTS: The search strategy identified 47 studies, of which 2 were included in this review, as they met the inclusion and exclusion criteria. Both evaluated the efficacy of venlafaxine in vestibular migraine, comparing the results with other drugs. The first study (2017) compared the effect of venlafaxine with flunarizine and valproic acid, while the second study (2015) compared the efficacy of venlafaxine with propranolol. Both showed improvement of vestibular symptoms in all groups evaluated, but only the groups submitted to treatment with venlafaxine showed a significant change in the emotional DHI (Dizziness Handicap Inventory) score and improvement in depressive symptoms. CONCLUSIONS: Although venlafaxine appears to have promising results, there is currently a scarcity of studies that allow currently to assess the efficacy and safety of the drug for the treatment of vestibular migraine. The evidence is quite limited, the number of studies and patients evaluated reduced, and it is recommended to conduct new quality randomized clinical trials to elucidate the issue.
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