Seedat S, Stein D J
Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa.
Int Clin Psychopharmacol. 1999 Nov;14(6):353-6. doi: 10.1097/00004850-199911000-00005.
Inositol, an isomer of glucose and precursor in the phosphatidylinositol cycle, may be effective in a number of psychiatric disorders, including obsessive-compulsive disorder (OCD). There is little data, however, on inositol as an augmenting agent of serotonin reuptake inhibitors (SRIs) in treatment-refractory patients. Ten OCD patients who had failed to respond to current and previous trials of serotonin reuptake inhibitors participated in open-label trial of inositol (18 gm/day) [corrected] augmentation for 6 weeks. Symptoms were rated at 2-weekly intervals using the Yale-Brown Obsessive-Compulsive Scale, the Montgomery-Asberg Depression Rating Scale, and the Clinical Global Impressions (CGI) Scale. The majority of patients (n = 7) did not respond to treatment with inositol augmentation on the CGI improvement item. However, a small number of patients (n = 3) did report a clinically significant response on the CGI improvement item. OCD patients who fail to respond to a number of trials of SRIs may be a particularly treatment-refractory group of subjects. Unfortunately, inositol augmentation of a SRI did not lead to significant improvement in the majority of such cases. Nevertheless, further research on the mechanism of inositol efficacy in some patients with anxiety and mood disorders is warranted.
肌醇是葡萄糖的异构体，也是磷脂酰肌醇循环的前体，可能对包括强迫症（OCD）在内的多种精神障碍有效。然而，关于肌醇作为难治性患者中5-羟色胺再摄取抑制剂（SRI）增效剂的数据很少。10名对当前及之前的5-羟色胺再摄取抑制剂试验均无反应的强迫症患者参与了肌醇（18克/天）增效的开放标签试验，为期6周。使用耶鲁-布朗强迫症量表、蒙哥马利-阿斯伯格抑郁评定量表和临床总体印象（CGI）量表，每隔2周对症状进行评分。大多数患者（n = 7）在CGI改善项目上对肌醇增效治疗无反应。然而，少数患者（n = 3）确实在CGI改善项目上报告了具有临床意义的反应。对多种SRI试验均无反应的强迫症患者可能是特别难治的一组受试者。不幸的是，在大多数此类病例中，SRI加用肌醇并未导致显著改善。尽管如此，仍有必要进一步研究肌醇对一些焦虑和情绪障碍患者有效的机制。
