{"id":2224,"date":"2022-01-04T11:22:44","date_gmt":"2022-01-04T02:22:44","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2224"},"modified":"2022-01-04T11:22:44","modified_gmt":"2022-01-04T02:22:44","slug":"maintenance-or-discontinuation-of-antidepressants-in-primary-care","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2224","title":{"rendered":"Maintenance or Discontinuation of Antidepressants in Primary Care"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nGemma Lewis, et al. Maintenance or Discontinuation of Antidepressants in Primary Care. The New England Journal of Medicine 2021; 385:1257-1267. (DOI: 10.1056\/NEJMoa2106356)<\/p>\n

\u2015\u8981\u7d04\u2015
\nBACKGROUND<\/strong>
\n\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u306e\u5b9f\u8df5\u3067\u6cbb\u7642\u3055\u308c\u3066\u3044\u308b\u3046\u3064\u75c5\u306e\u60a3\u8005\u306f\uff0c\u9577\u671f\u9593\u6297\u3046\u3064\u85ac\u3092\u670d\u7528\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\uff0e\u3053\u306e\u8a2d\u5b9a\u3067\u6297\u3046\u3064\u85ac\u7642\u6cd5\u3092\u7dad\u6301\u307e\u305f\u306f\u4e2d\u6b62\u3057\u305f\u5834\u5408\u306e\u5f71\u97ff\u306b\u95a2\u3059\u308b\u30c7\u30fc\u30bf\u306f\u9650\u3089\u308c\u3066\u3044\u308b\uff0e<\/p>\n

METHODS<\/strong>
\n\u82f1\u56fd\u5185\u306e150\u306e\u4e00\u822c\u8a3a\u7642\u6240\u3067\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u305f\u6210\u4eba\u3092\u5bfe\u8c61\u3068\u3057\u305f\u30e9\u30f3\u30c0\u30e0\u5316\u4e8c\u91cd\u76f2\u691c\u8a66\u9a13\u3092\u5b9f\u65bd\u3057\u305f\uff0e\u3059\u3079\u3066\u306e\u60a3\u8005\u306f\uff0c\u5c11\u306a\u304f\u3068\u30822\u56de\u306e\u3046\u3064\u75c5\u30a8\u30d4\u30bd\u30fc\u30c9\u306e\u75c5\u6b74\u304c\u3042\u308b\u304b\uff0c2\u5e74\u4ee5\u4e0a\u6297\u3046\u3064\u85ac\u3092\u670d\u7528\u3057\u3066\u304a\u308a\uff0c\u6297\u3046\u3064\u85ac\u306e\u4e2d\u6b62\u3092\u691c\u8a0e\u3059\u308b\u306e\u306b\u5341\u5206\u306a\u610f\u601d\u304c\u3042\u3063\u305f\uff0e\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\uff0c\u30d5\u30eb\u30aa\u30ad\u30bb\u30c1\u30f3\uff0c\u30bb\u30eb\u30c8\u30e9\u30ea\u30f3\uff0c\u307e\u305f\u306f\u30df\u30eb\u30bf\u30b6\u30d4\u30f3\u3092\u6295\u4e0e\u3055\u308c\u305f\u60a3\u8005\u306f\uff0c\u73fe\u5728\u306e\u6297\u3046\u3064\u7642\u6cd5\u3092\u7dad\u6301\u3059\u308b\u7dad\u6301\u7fa4\uff0c\u307e\u305f\u306f\u5bfe\u5fdc\u3059\u308b\u30d7\u30e9\u30bb\u30dc\u3092\u4f7f\u7528\u3057\u3066\u305d\u306e\u3088\u3046\u306a\u7642\u6cd5\u3092\u6f38\u6e1b\u304a\u3088\u3073\u4e2d\u6b62\u3059\u308b\u4e2d\u6b62\u7fa4\u306b\uff0c1\uff1a1\u306e\u6bd4\u7387\u3067\u30e9\u30f3\u30c0\u30e0\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u305f\uff0e\u4e00\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\uff0c\u30a4\u30d9\u30f3\u30c8\u307e\u3067\u306e\u6642\u9593\u5206\u6790\u3067\u8a55\u4fa1\u3055\u308c\u305f52\u9031\u9593\u306e\u8a66\u9a13\u671f\u9593\u4e2d\u306b\u304a\u3051\u308b\u3046\u3064\u75c5\u306e\u518d\u767a\u3060\u3063\u305f\uff0e\u4e8c\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\uff0c\u6291\u3046\u3064\u304a\u3088\u3073\u4e0d\u5b89\u75c7\u72b6\uff0c\u8eab\u4f53\u5316\u75c7\u72b6\u304a\u3088\u3073\u96e2\u8131\u75c7\u72b6\uff0c\u751f\u6d3b\u306e\u8cea\uff0c\u6297\u3046\u3064\u85ac\u307e\u305f\u306f\u30d7\u30e9\u30bb\u30dc\u4e2d\u6b62\u304b\u3089\u306e\u6642\u9593\uff0c\u5168\u822c\u7684\u306a\u6c17\u5206\u5c3a\u5ea6\u3067\u8a55\u4fa1\u3057\u305f\uff0e<\/p>\n

RESULTS<\/strong>
\n\u5408\u8a081466\u4eba\u306e\u60a3\u8005\u304c\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3092\u53d7\u3051\u305f\uff0e\u3053\u308c\u3089\u306e\u60a3\u8005\u306e\u3046\u3061\uff0c478\u4eba\u304c\u8a66\u9a13\u306b\u767b\u9332\u3055\u308c\u305f\uff08\u7dad\u6301\u7fa4238\u4eba\uff0c\u4e2d\u6b62\u7fa4240\u4eba\uff09\uff0e\u60a3\u8005\u306e\u5e73\u5747\u5e74\u9f62\u306f54\u6b73\u3067\uff0c73\uff05\u306f\u5973\u6027\u3060\u3063\u305f\uff0e\u8a66\u9a13\u8ab2\u984c\u306e\u30a2\u30c9\u30d2\u30a2\u30e9\u30f3\u30b9\u306f\uff0c\u7dad\u6301\u7fa4\u306770\uff05\uff0c\u4e2d\u6b62\u7fa4\u306752\uff05\u3060\u3063\u305f\uff0e52\u9031\u9593\u307e\u3067\u306b\u518d\u767a\u306f\u7dad\u6301\u7fa4\u306e928\u4eba\u4e2d92\u4eba\uff0839\uff05\uff09\uff0c\u4e2d\u6b62\u7fa4\u306e240\u4eba\u4e2d135\u4eba\uff0856\uff05\uff09\u3067\u767a\u751f\u3057\u305f\uff08\u30cf\u30b6\u30fc\u30c9\u6bd42.06; 95\uff05\u4fe1\u983c\u533a\u95931.56\u301c2.70; P <0.001 \uff09\uff0e\u4e8c\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\uff0c\u4e00\u822c\u7684\u306b\u4e00\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u540c\u3058\u65b9\u5411\u3060\u3063\u305f\uff0e\u4e2d\u6b62\u7fa4\u306e\u60a3\u8005\u306f\uff0c\u7dad\u6301\u7fa4\u306e\u60a3\u8005\u3088\u308a\u3082\u3046\u3064\u75c5\uff0c\u4e0d\u5b89\uff0c\u96e2\u8131\u306e\u75c7\u72b6\u304c\u591a\u304b\u3063\u305f\uff0e\n\"\"<\/a><\/p>\n

CONCLUSION<\/strong>
\n\u6297\u3046\u3064\u85ac\u6cbb\u7642\u3092\u4e2d\u6b62\u3059\u308b\u306e\u306b\u5341\u5206\u306a\u610f\u601d\u304c\u3042\u3063\u305f\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u306e\u60a3\u8005\u306e\u4e2d\u3067\uff0c\u6295\u85ac\u3092\u4e2d\u6b62\u3059\u308b\u3088\u3046\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u305f\u60a3\u8005\u306f\uff0c\u73fe\u5728\u306e\u6cbb\u7642\u3092\u7dad\u6301\u3059\u308b\u3088\u3046\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u305f\u60a3\u8005\u3088\u308a\u308252\u9031\u9593\u307e\u3067\u306b\u3046\u3064\u75c5\u306e\u518d\u767a\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u304b\u3063\u305f\uff0e<\/p>\n

DISCUSSION<\/strong>
\n\u672c\u8a66\u9a13\u3067\u6297\u3046\u3064\u85ac\u306e\u670d\u7528\u3092\u4e2d\u6b62\u3059\u308b\u3088\u3046\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u305f\u30b0\u30eb\u30fc\u30d7\u306e\u60a3\u8005\u306f\uff0c52\u9031\u9593\u306e\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u3092\u901a\u3057\u3066\u85ac\u3092\u670d\u7528\u3057\u7d9a\u3051\u308b\u3088\u3046\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u305f\u60a3\u8005\u3088\u308a\u3082\u3046\u3064\u75c5\u306e\u518d\u767a\u306e\u983b\u5ea6\u304c\u9ad8\u304b\u3063\u305f\uff0eSF-12\u306e\u8eab\u4f53\u7684\u5065\u5eb7\u8981\u7d20\u3068\u30c8\u30ed\u30f3\u30c8\u306e\u526f\u4f5c\u7528\u30b9\u30b1\u30fc\u30eb\u306e\u30b9\u30b3\u30a2\u3092\u9664\u3044\u3066\uff0c\u4e8c\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u4e00\u822c\u7684\u306b\u4e00\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u540c\u3058\u65b9\u5411\u3060\u3063\u305f\uff0e\u8a66\u9a13\u306e\u7d42\u308f\u308a\u307e\u3067\u306b\uff0c\u4e2d\u6b62\u7fa4\u306e\u60a3\u8005\u306e39\uff05\u304c\u81e8\u5e8a\u533b\u306b\u3088\u3063\u3066\u51e6\u65b9\u3055\u308c\u305f\u6297\u3046\u3064\u85ac\u306e\u670d\u7528\u306b\u623b\u3063\u3066\u3044\u305f\uff0e\u3053\u308c\u306f\uff0c52\u9031\u306b\u304a\u3051\u308b\u6700\u5f8c\u306e\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u3067\u4e8c\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u7fa4\u9593\u5dee\u306e\u8a3c\u62e0\u304c\u306a\u304b\u3063\u305f\u7406\u7531\u3092\u8aac\u660e\u3057\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\uff0e
\n\u30df\u30eb\u30bf\u30b6\u30d4\u30f3\uff08\u30ce\u30eb\u30a2\u30c9\u30ec\u30ca\u30ea\u30f3\u4f5c\u52d5\u6027\u304a\u3088\u3073\u7279\u5b9a\u306e\u30bb\u30ed\u30c8\u30cb\u30f3\u4f5c\u52d5\u6027\u6297\u3046\u3064\u85ac\uff09\u3068\u3068\u3082\u306b\uff0c\u540c\u69d8\u306e\u85ac\u7406\u5b66\u7684\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u304a\u3088\u3073\u540c\u69d8\u306e\u6d3b\u6027\u30e1\u30ab\u30cb\u30ba\u30e0\u3092\u6709\u3059\u308b3\u3064\u306eSSRI\u306e\u307f\u3092\u8abf\u67fb\u3057\u305f\u305f\u3081\uff0c\u4ed6\u306e\u30af\u30e9\u30b9\u306e\u6297\u3046\u3064\u85ac\u306b\u8abf\u67fb\u7d50\u679c\u3092\u4e00\u822c\u5316\u3059\u308b\u3053\u3068\u306f\u3067\u304d\u306a\u3044\uff0e\u672c\u8a66\u9a13\u306e\u3082\u30461\u3064\u306e\u9650\u754c\u306f\uff0c\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u3092\u670d\u7528\u3057\u3066\u3044\u308b\u60a3\u8005\u3068\uff0c\u82f1\u56fd\u306e\u7dad\u6301\u7642\u6cd5\u306e\u901a\u5e38\u306e\u7528\u91cf\u3068\u306f\u7570\u306a\u308b\u7528\u91cf\u306e\u8a66\u9a13\u85ac\u3092\u670d\u7528\u3057\u3066\u3044\u308b\u60a3\u8005\u3092\u9664\u5916\u3057\u305f\u3053\u3068\u304c\u6319\u3052\u3089\u308c\u308b\uff0e \u3055\u3089\u306b\u8a66\u9a13\u306b\u63a1\u7528\u3055\u308c\u305f\u60a3\u8005\u306e\u3054\u304f\u4e00\u90e8\u306e\u307f\u304c\u6700\u7d42\u7684\u306b\u53c2\u52a0\u3057\uff0c\u3053\u308c\u304c\u8a66\u9a13\u30b5\u30f3\u30d7\u30eb\u306b\u30d0\u30a4\u30a2\u30b9\u3092\u3082\u305f\u3089\u3057\u305f\u53ef\u80fd\u6027\u304c\u3042\u308b\uff0e\u91cd\u8981\u306a\u5236\u9650\u306f\uff0c\u4eca\u56de\u306e\u8abf\u67fb\u7d50\u679c\u306f\uff0c\u6295\u85ac\u3092\u4e2d\u6b62\u3059\u308b\u6e96\u5099\u304c\u3067\u304d\u3066\u3044\u308b\u3068\u611f\u3058\u305f\u60a3\u8005\u306b\u306e\u307f\u95a2\u4fc2\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3042\u308b\uff0e\u3046\u3064\u75c5\u306e\u518d\u767a\u3092\u6c7a\u5b9a\u3059\u308b\u65b9\u6cd5\u306f\uff0c\u4e00\u90e8\u306b\u306f\u904e\u53bb12\u9031\u9593\u306b\u308f\u305f\u3063\u3066\u60a3\u8005\u306b\u75c7\u72b6\u3092\u9061\u53ca\u7684\u306b\u8a55\u4fa1\u3055\u305b\u308b\u5fc5\u8981\u304c\u3042\u308b\u305f\u3081\uff0c\u8a66\u9a13\u306e\u76ee\u7684\u306e\u305f\u3081\u306b\u5f93\u6765\u306e\u30c7\u30fc\u30bf\u304b\u3089\u63a1\u7528\u3055\u308c\u305f\uff0e\u672c\u8a66\u9a13\u306e\u96c6\u56e3\u306f\uff0c\u6c11\u65cf\u306e\u591a\u69d8\u6027\u306b\u6b20\u3051\u3066\u304a\u308a\uff0c\u3059\u3079\u3066\u306e\u60a3\u8005\u304c\u82f1\u56fd\u306e\u533b\u7642\u5236\u5ea6\u3067\u6cbb\u7642\u3055\u308c\u3066\u3044\u305f\u305f\u3081\uff0c\u767d\u4eba\u4ee5\u5916\u306e\u60a3\u8005\u3084\u4ed6\u306e\u533b\u7642\u5236\u5ea6\u306b\u7d50\u679c\u3092\u4e00\u822c\u5316\u3059\u308b\u3053\u3068\u306f\u3067\u304d\u306a\u3044\uff0e
\n\u6297\u3046\u3064\u85ac\u3092\u4f55\u5e74\u3082\u5e38\u7528\u3057\u3066\u3044\u308b\u60a3\u8005\u3092\u52df\u96c6\u3057\uff0c\u3046\u3064\u75c5\u306e\u75c5\u6b74\u3068\u305d\u306e\u6cbb\u7642\u6cd5\u3092\u601d\u3044\u51fa\u3057\u3066\u3082\u3089\u3063\u305f\uff0e\u60f3\u8d77\u30d0\u30a4\u30a2\u30b9\u304c\u672c\u8a66\u9a13\u306e\u7d50\u679c\u306e\u59a5\u5f53\u6027\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u53ef\u80fd\u6027\u306f\u4f4e\u3044\u304c\uff0c\u60a3\u8005\u304c\u63d0\u4f9b\u3057\u305f\u60c5\u5831\u306e\u6b63\u78ba\u3055\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\uff0e\u307e\u305f\uff0c\u5f53\u6642\uff0c\u6297\u3046\u3064\u85ac\u3092\u51e6\u65b9\u3059\u308b\u305f\u3081\u306e\u5f53\u521d\u306e\u81e8\u5e8a\u7684\u6c7a\u5b9a\u306b\u95a2\u3059\u308b\u8a73\u7d30\u306a\u60c5\u5831\u3084\u8a3a\u65ad\u60c5\u5831\u3082\u306a\u304b\u3063\u305f\uff0e
\n\u3046\u3064\u75c5\u306e\u6cbb\u7642\u3092\u53d7\u3051\uff0c\u6297\u3046\u3064\u85ac\u306e\u6295\u4e0e\u3092\u4e2d\u6b62\u3059\u308b\u610f\u601d\u306e\u3042\u308b\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u306e\u60a3\u8005\u3067\u306f\uff0c52\u9031\u9593\u306e\u671f\u9593\u4e2d\uff0c\u3046\u3064\u75c5\u306e\u518d\u767a\u30ea\u30b9\u30af\u306f\uff0c\u7dad\u6301\u7fa4\u306e\u60a3\u8005\u3088\u308a\u3082\u4e2d\u6b62\u7fa4\u306e\u60a3\u8005\u306e\u65b9\u304c\u9ad8\u304b\u3063\u305f\uff0e\u751f\u6d3b\u306e\u8cea\u306e\u30b9\u30b3\u30a2\uff0c\u3046\u3064\u75c5\uff0c\u4e0d\u5b89\u795e\u7d4c\u75c7\uff0c\u7981\u65ad\u75c7\u72b6\u306f\uff0c\u6297\u3046\u3064\u85ac\u6cbb\u7642\u3092\u4e2d\u6b62\u3057\u305f\u60a3\u8005\u3067\u306f\u4e00\u822c\u7684\u306b\u60aa\u5316\u3057\u305f\uff0e<\/p>\n

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\n2021\u5e7410\u67086\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u2015\u6587\u732e\u540d\u2015 Gemma Lewis, et al. Maintenance or Discontinuation of Antidepressants in Primary Care. The New England J … \u7d9a\u304d\u3092\u8aad\u3080 Maintenance or Discontinuation of Antidepressants in Primary Care<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[],"class_list":["post-2224","post","type-post","status-publish","format-standard","hentry","category-15"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2224","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2224"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2224\/revisions"}],"predecessor-version":[{"id":2226,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2224\/revisions\/2226"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2224"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2224"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2224"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}