一项针对难治性强迫症儿童的开放性试验，使用谷氨酸拮抗剂利鲁唑。
An open-label trial of riluzole, a glutamate antagonist, in children with treatment-resistant obsessive-compulsive disorder.
作者信息
Grant Paul, Lougee Lorraine, Hirschtritt Matthew, Swedo Susan E
机构信息
Pediatrics and Developmental Neuropsychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
出版信息
J Child Adolesc Psychopharmacol. 2007 Dec;17(6):761-7. doi: 10.1089/cap.2007.0021.
BACKGROUND
Obsessive-compulsive disorder (OCD) in childhood is often refractory to treatment. Riluzole, a glutamate antagonist, has theoretical support as an alternative pharmacological treatment and has demonstrated possible benefit in some open-label trials in adults with OCD.
METHODS
Six subjects, ages 8-16 years, were enrolled in a 12-week open-label trial of riluzole for OCD symptoms that had resisted prior treatments. OCD symptoms and adverse effects of drug were monitored.
RESULTS
Four of 6 subjects had clear benefit, with reduction of more than 46% (39% overall) on Children's Yale-Brown Obsessive-Compulsive Scale, and "Much Improved" or "Very Much Improved" on the Clinical Global Impressions-Improvement scale. Two subjects had no clinically meaningful change in symptom severity by 12 weeks, but 1 subject improved thereafter. There were no adverse effects of drug sufficient to cause discontinuation or reduction of dose. All subjects elected to continue riluzole after the 12-week trial.
CONCLUSIONS
Riluzole may be beneficial for treatment-resistant OCD in young subjects and seems well tolerated. A placebo-controlled trial of the drug is planned.
背景
儿童强迫症（OCD）通常对治疗具有难治性。利鲁唑是一种谷氨酸拮抗剂，作为一种替代性药物治疗具有理论依据，并且在一些针对成年强迫症患者的开放标签试验中已显示出可能的益处。
方法
6名年龄在8至16岁之间的受试者参加了一项为期12周的利鲁唑开放标签试验，用于治疗先前治疗无效的强迫症症状。监测强迫症症状和药物不良反应。
结果
6名受试者中有4名明显受益，儿童耶鲁-布朗强迫症量表评分降低超过46%（总体降低39%），临床总体印象改善量表评分为“明显改善”或“非常明显改善”。2名受试者在12周时症状严重程度无临床意义上的变化，但有1名受试者此后有所改善。没有足以导致停药或减药的药物不良反应。所有受试者在12周试验后均选择继续服用利鲁唑。
结论
利鲁唑可能对年轻受试者中难治性强迫症有益，且耐受性良好。计划对该药物进行安慰剂对照试验。
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