Mavrogiorgou P, Hegerl U
Klinik d. LMU, München.
MMW Fortschr Med. 1999 Sep 30;141(39):32-4, 37.
Pharmacotherapy which, together with behavior therapy, is a major pillar in the treatment of obsessive-compulsive disorder (OCD), can bring about a distinct symptomatic improvement in 50-70% of the patients. In addition to the classical tricyclic antidepressant, clomipramine, a number of new selective serotonin reuptake inhibitors have now been approved for the treatment of OCD. In comparison with depression, pharmacotherapy of OCD is characterized by a long latency of effect of eight to twelve weeks, and by the high doses required by some patients. A combination of pharmacotherapy and behavior therapy is superior to behavior therapy alone, in particular in the case of patients with predominantly obsessive thoughts and additional symptoms of depression. In the case of aggregation with the Tourette syndrome or schizotypal personality disorders, the additional administration of a neuroleptic is recommended. Open studies and case histories have reported good results with pimozide, haloperidol, clozapine and risperidone.
药物治疗是强迫症（OCD）治疗的主要支柱之一，与行为疗法一起，可使50-70%的患者症状明显改善。除了经典的三环类抗抑郁药氯米帕明外，现在已有多种新型选择性5-羟色胺再摄取抑制剂被批准用于治疗强迫症。与抑郁症相比，强迫症的药物治疗具有起效潜伏期长达8至12周以及部分患者所需剂量高的特点。药物治疗与行为疗法相结合优于单纯的行为疗法，尤其是对于主要有强迫观念和伴有抑郁附加症状的患者。对于合并抽动秽语综合征或分裂型人格障碍的情况，建议加用抗精神病药。开放性研究和病例报告显示，匹莫齐特、氟哌啶醇、氯氮平和利培酮治疗效果良好。
