vrijdag 4 september 2015

Rhodiola versus sertraline bij depressie

Rhodiola rosea werkt minder goed dan het antidepressivum sertraline, maar heeft wel beduidend minder bijwerkingen. Dat melden wetenschappers van de universiteit van Pennsylvania, die de twee remedies met elkaar vergeleken bij patiënten met milde depressie. Ze stellen zelfs dat rhodiola een gunstigere risico-baten-profiel heeft dan sertraline.

Het gebruik van antidepressiva bij milde depressie staat ter discussie. Het grootste deel van de effecten zijn toe te schrijven aan placebo en de bijwerkingen zijn buiten proportie. Ook in deze studie klaagde bijna tweede derde van de patiënten die sertraline namen over bijwerkingen. In de rhodiola- en placebogroep lag dat percentage op resp. 30 % en 16 %.

Phytomedicine. 2015 Mar 15;22(3):394-9. doi: 10.1016/j.phymed.2015.01.010. Epub 2015 Feb 23. Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial.
Mao JJ1, Xie SX2, Zee J2, Soeller I3, Li QS3, Rockwell K4, Amsterdam JD5.

BACKGROUND:
We performed a proof of concept trial to evaluate relative safety and efficacy of Rhodiola rosea (R. rosea) versus sertraline for mild to moderate major depressive disorder.
HYPOTHESIS:
We hypothesize that R. rosea would have similar therapeutic effects as sertraline but with less adverse events.
STUDY DESIGN:
Phase II randomized placebo controlled clinical trial.
METHODS:
57 subjects were randomized to 12 weeks of standardized R. rosea extract, sertraline, or placebo. Changes over time in Hamilton Depression Rating (HAM-D), Beck Depression Inventory (BDI), and Clinical Global Impression Change (CGI/C) scores among groups were examined using mixed-effects models.
RESULTS:
Modest, albeit statistically non-significant, reductions were observed for HAM-D, BDI, and CGI/C scores for all treatment conditions with no significant difference between groups (p = 0.79, p = 0.28, and p = 0.17, respectively). The decline in HAM-D scores was greater for sertraline (-8.2, 95% confidence interval [CI], -12.7 to -3.6) versus R. rosea (-5.1, 95% CI: -8.8 to -1.3) and placebo (-4.6, 95% CI: -8.6 to -0.6). While the odds of improving (versus placebo) were greater for sertraline (1.90 [0.44-8.20]; odds ratio [95% CI]) than R. rosea (1.39 [0.38-5.04]), more subjects on sertraline reported adverse events (63.2%) than R. rosea (30.0%) or placebo (16.7%) (p = 0.012).
CONCLUSIONS:
Although R. rosea produced less antidepressant effect versus sertraline, it also resulted in significantly fewer adverse events and was better tolerated. These findings suggest that R. rosea, although less effective than sertraline, may possess a more favorable risk to benefit ratio for individuals with mild to moderate depression.

Referentie(s)
Mao JJ, Xie SX, Zee J et al. Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial. Phytomedicine. 2015 Mar 15;22(3):394-9

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