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阿立哌唑增效治疗难治性强迫症中选择性 5-羟色胺再摄取抑制剂或氯米帕明的疗效:一项双盲、安慰剂对照研究。

Effect of aripiprazole augmentation of serotonin reuptake inhibitors or clomipramine in treatment-resistant obsessive-compulsive disorder: a double-blind, placebo-controlled study.

机构信息

Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Messina, Italy.

出版信息

J Clin Psychopharmacol. 2011 Apr;31(2):174-9. doi: 10.1097/JCP.0b013e31820e3db6.

Abstract

Based on the evidence that aripiprazole added to serotonin reuptake inhibitors (SRIs) or clomipramine in treatment-resistant obsessive-compulsive disorder (OCD) has reported promising results, the present 16-week, double-blind, randomized, placebo-controlled trial had the aim to explore the efficacy of aripiprazole add-on pharmacotherapy on clinical symptoms and cognitive functioning in a sample of treatment-resistant OCD patients receiving SRIs. After clinical and neurocognitive assessments, patients were randomly allocated to receive, in a double-blind design, 15 mg/d of aripiprazole or a placebo. A final sample of 30 patients completed the study. The results obtained indicate that aripiprazole added to stable SRI treatment substantially improved obsessive-compulsive symptoms as measured by changes on the Yale-Brown Obsessive Compulsive Scale total score and subscores (obsessions, P = 0.007; compulsions, P = 0.001; total score, P < 0.0001). Regarding cognitive functions, improvement was observed in some explored areas, such as attentional resistance to interference (Stroop score, P = 0.001) and executive functioning (perseverative errors, P = 0.015). The findings provide evidence that aripiprazole augmentation of SRIs/clomipramine treatment is well tolerated and may be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant OCD.

摘要

基于阿立哌唑联合选择性 5-羟色胺再摄取抑制剂(SSRIs)或氯米帕明治疗难治性强迫症(OCD)的证据表明具有良好的效果,本为期 16 周的双盲、随机、安慰剂对照试验旨在探索在接受 SSRIs 治疗的难治性 OCD 患者样本中,阿立哌唑附加药物治疗对临床症状和认知功能的疗效。在进行临床和神经认知评估后,患者被随机分配接受阿立哌唑(剂量为 15mg/d)或安慰剂的双盲治疗。最终有 30 名患者完成了研究。结果表明,阿立哌唑联合稳定的 SSRIs 治疗可显著改善强迫症症状,表现在耶鲁-布朗强迫症量表总分和子量表(强迫观念,P = 0.007;强迫行为,P = 0.001;总分,P < 0.0001)上。关于认知功能,在一些探索性领域观察到了改善,例如注意力抗干扰(Stroop 评分,P = 0.001)和执行功能(持续错误,P = 0.015)。这些发现为阿立哌唑联合 SSRIs/氯米帕明治疗提供了证据,表明其具有良好的耐受性,并且可能是一种有效的治疗策略,可改善难治性 OCD 的治疗效果。

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