Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
J Psychopharmacol. 2012 Jun;26(6):887-90. doi: 10.1177/0269881111405363. Epub 2011 Jul 11.
We report about a clinical observation in a well-characterized group of patients with obsessive-compulsive disorder (OCD) during an experimental medicine study in which a single dose of amisulpride (a selective D₂/₃ antagonist) was administered. Almost half of the OCD patients, in particular those with less severe obsessive-compulsive symptoms, experienced acute akathisia in response to the amisulpride challenge. This unexpectedly high incidence of akathisia in the selective serotonin reuptake inhibitor (SSRI)-treated patients with OCD suggests that individual differences in dopamine-serotonin interactions underlie the clinical heterogeneity of OCD, and may thus explain the insufficiency of SSRI monotherapy in those patients not experiencing a satisfactory outcome in symptom reduction. We further speculate about the neuropathology possibly underlying this clinical observation and outline a testable hypothesis for future molecular imaging studies.
我们报告了一项在一组特征明确的强迫症（OCD）患者中进行的实验医学研究的临床观察结果，该研究中给予了单剂量的氨磺必利（一种选择性 D₂/₃拮抗剂）。几乎一半的 OCD 患者，特别是那些强迫症症状较轻的患者，在氨磺必利挑战中出现急性静坐不能。在接受选择性 5-羟色胺再摄取抑制剂（SSRI）治疗的 OCD 患者中，这种静坐不能的发生率异常高，这表明多巴胺-5-羟色胺相互作用的个体差异是 OCD 临床异质性的基础，因此可以解释为什么在那些症状减轻没有达到满意效果的患者中，SSRI 单一疗法并不适用。我们进一步推测了这种临床观察可能的神经病理学基础，并为未来的分子影像学研究提出了一个可检验的假设。
