Arch Gen Psychiatry. 1991 Aug;48(8):730-8. doi: 10.1001/archpsyc.1991.01810320054008.
Two double-blind studies at 21 centers evaluated the therapeutic efficacy, safety, and tolerability of up to 300 mg/d of clomipramine hydrochloride or an equivalent number of placebo capsules in the treatment of 520 patients with obsessive-compulsive disorder, of whom 239 had had the disorder for at least 2 years (study 1) and 281 had been ill for at least 1 year (study 2). On the two principal measures of the severity of the disorder, ie, the Yale-Brown Obsessive Compulsive Scale and the National Institute of Mental Health Global Obsessive Compulsive Scale, clomipramine was significantly more effective than placebo in both studies. The mean reduction in the Yale-Brown Obsessive Compulsive Scale score at the end of 10 weeks of treatment was 38% and 44% in studies 1 and 2, respectively, for the clomipramine-treated patients and 3% and 5% for the placebo-treated patients. The drug was also found to be superior on the basis of the physicians' and patients' evaluations of global therapeutic change. The most frequently observed adverse effects during clomipramine therapy were those typically associated with tricyclic antidepressant drugs. Although uncommon, the occurrence of seizures and elevated aminotransferase values are potentially serious side effects of clomipramine. Clomipramine was generally well tolerated and was effective in reducing obsessive and compulsive symptoms.
两项在21个中心开展的双盲研究，评估了每日高达300毫克盐酸氯米帕明或等量安慰剂胶囊，对520例强迫症患者的治疗效果、安全性及耐受性。其中239例患者患病至少2年（研究1），281例患者患病至少1年（研究2）。在该疾病严重程度的两项主要衡量指标，即耶鲁-布朗强迫症量表和美国国立精神卫生研究所强迫症整体量表上，氯米帕明在两项研究中均显著比安慰剂更有效。治疗10周结束时，在研究1和研究2中，接受氯米帕明治疗的患者耶鲁-布朗强迫症量表评分平均降低分别为38%和44%，而接受安慰剂治疗的患者分别为3%和5%。基于医生和患者对整体治疗变化的评估，该药物也被发现更具优势。氯米帕明治疗期间最常观察到的不良反应是那些通常与三环类抗抑郁药相关的反应。虽然不常见，但癫痫发作和转氨酶值升高是氯米帕明潜在的严重副作用。氯米帕明总体耐受性良好，在减轻强迫症状方面有效。
