Goodman W K, McDougle C J, Price L H
Clinical Neuroscience Research Unit, Yale University School of Medicine, New Haven, CT 06519.
J Clin Psychiatry. 1992 Apr;53 Suppl:29-37.
The authors briefly review studies of the efficacy of potent serotonin reuptake inhibitors (SRIs) (e.g., clomipramine, fluvoxamine) in obsessive compulsive disorder (OCD) and compare the use of antidepressants in the treatment of depression and OCD. They propose an algorithm for those patients with OCD who fail to respond to an adequate trial with a potent SRI and discuss the promise and limitations of adding tryptophan, fenfluramine, lithium, buspirone, or a neuroleptic to ongoing SRI therapy. Other biological approaches (e.g., ECT, psychosurgery) are considered in terms of their narrowly defined roles in the treatment of patients with SRI-resistant OCD.
作者简要回顾了强效5-羟色胺再摄取抑制剂（SRI，如氯米帕明、氟伏沙明）治疗强迫症（OCD）的疗效研究，并比较了抗抑郁药在治疗抑郁症和强迫症中的应用。他们为那些对足量强效SRI治疗无反应的强迫症患者提出了一种算法，并讨论了在持续的SRI治疗中添加色氨酸、芬氟拉明、锂盐、丁螺环酮或抗精神病药物的前景和局限性。还从其在治疗对SRI耐药的强迫症患者中所起的狭义作用方面，对其他生物学方法（如ECT、精神外科手术）进行了考量。
