Coric Vladimir, Taskiran Sarper, Pittenger Christopher, Wasylink Suzanne, Mathalon Daniel H, Valentine Gerald, Saksa John, Wu Yu-Te, Gueorguieva Ralitza, Sanacora Gerard, Malison Robert T, Krystal John H
Department of Psychiatry, Yale University School of Medicine and Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA.
Biol Psychiatry. 2005 Sep 1;58(5):424-8. doi: 10.1016/j.biopsych.2005.04.043.
Most patients with obsessive-compulsive disorder (OCD) show only partial reduction of symptoms with standard therapy. Recent imaging data suggests glutamatergic dysfunction in the corticostriatal pathway in OCD. We investigated the efficacy of augmentation therapy with riluzole, a glutamate-modulating agent, in treatment-resistant OCD.
Thirteen patients aged between 18 and 65 years with a primary diagnosis of OCD that had proven resistant to standard treatment were treated with the addition of riluzole to their existing pharmacotherapy. Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression Inventory (HAM-D), and Hamilton Anxiety Inventory (HAM-A) scores were obtained weekly.
Thirteen treatment-resistant OCD patients received riluzole 50 mg twice a day. Y-BOCS scores improved significantly over time. Of 13 patients, 7 (54%) demonstrated a >35% reduction in Y-BOCS scores, and 5 (39%) were categorized as treatment responders. HAM-D and HAM-A scores for the group also significantly improved over time. Riluzole was well tolerated with no serious adverse effects noted.
Riluzole appears to have significant antiobsessional, antidepressant, and antianxiety properties. The addition of this agent may be of practical clinical benefit in patients with OCD.
大多数强迫症（OCD）患者接受标准治疗后症状仅部分减轻。近期影像学数据表明强迫症患者的皮质纹状体通路存在谷氨酸能功能障碍。我们研究了谷氨酸调节剂利鲁唑强化治疗难治性强迫症的疗效。
13例年龄在18至65岁之间、原发性诊断为强迫症且已证实对标准治疗耐药的患者，在其现有药物治疗基础上加用利鲁唑进行治疗。每周获取耶鲁布朗强迫症量表（Y - BOCS）、汉密尔顿抑郁量表（HAM - D）和汉密尔顿焦虑量表（HAM - A）评分。
13例难治性强迫症患者接受每日两次50毫克利鲁唑治疗。Y - BOCS评分随时间显著改善。13例患者中，7例（54%）Y - BOCS评分降低超过35%，5例（39%）被归类为治疗有效者。该组患者的HAM - D和HAM - A评分也随时间显著改善。利鲁唑耐受性良好，未观察到严重不良反应。
利鲁唑似乎具有显著的抗强迫、抗抑郁和抗焦虑特性。添加该药物可能对强迫症患者具有实际临床益处。
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