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舍曲林与胍法辛联合治疗强迫症合并注意缺陷多动障碍的疗效:两个病例研究

Treatment Efficacy of Combined Sertraline and Guanfacine in Comorbid Obsessive-Compulsive Disorder and Attention Deficit/Hyperactivity Disorder: Two Case Studies.

作者信息

Taormina Shibany P, Galloway Matthew P, Rosenberg David R

机构信息

*Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI; †Department of Psychiatry, Children's Hospital of Michigan, Detroit, MI; ‡Department of Anesthesiology, Wayne State University School of Medicine, Detroit, MI.

出版信息

J Dev Behav Pediatr. 2016 Jul-Aug;37(6):491-5. doi: 10.1097/DBP.0000000000000290.

DOI:10.1097/DBP.0000000000000290
PMID:27011005
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4930387/
Abstract

OBJECTIVE

Treatment of obsessive-compulsive disorder (OCD) is complicated by comorbid psychiatric disorders. Successful treatment of 2 pediatric patients with severe OCD and comorbid attention deficit/hyperactivity disorder (ADHD) is described.

METHOD

A report on 2 pediatric clinical cases (Ages 9 and 10) with comorbid OCD and ADHD was used to describe response to medication management through the serotonin transporter inhibitor, sertraline, and the noradrenergic α2A receptor agonist, guanfacine, along with cognitive behavioral therapy.

RESULTS

Cognitive behavioral therapy combined with titrated doses of the serotonin transporter inhibitor, sertraline, and the noradrenergic α2A receptor agonist, guanfacine resolved OCD symptoms and the underlying ADHD.

CONCLUSION

The novel observations support a focused psychological and pharmacological approach to successful treatment of complex symptoms in patients with comorbid OCD and ADHD. Limitations to generalizability are discussed.

摘要

目的

强迫症(OCD)的治疗因合并精神疾病而变得复杂。本文描述了2例患有严重强迫症并合并注意力缺陷多动障碍(ADHD)的儿科患者的成功治疗案例。

方法

一份关于2例患有强迫症和ADHD的儿科临床病例(年龄分别为9岁和10岁)的报告,用于描述通过5-羟色胺转运体抑制剂舍曲林、去甲肾上腺素能α2A受体激动剂胍法辛以及认知行为疗法进行药物治疗的反应。

结果

认知行为疗法联合滴定剂量的5-羟色胺转运体抑制剂舍曲林和去甲肾上腺素能α2A受体激动剂胍法辛,缓解了强迫症症状及潜在的ADHD症状。

结论

这些新的观察结果支持采用有针对性的心理和药物治疗方法,成功治疗合并强迫症和ADHD患者的复杂症状。同时讨论了研究结果推广性的局限性。

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本文引用的文献

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In vivo effects of ketamine on glutamate-glutamine and gamma-aminobutyric acid in obsessive-compulsive disorder: Proof of concept.氯胺酮对强迫症患者谷氨酸 - 谷氨酰胺和γ-氨基丁酸的体内作用:概念验证
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Brain abnormalities in attention-deficit hyperactivity disorder: a review.注意缺陷多动障碍中的脑异常:综述
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The neurobiological link between OCD and ADHD.强迫症与注意力缺陷多动障碍之间的神经生物学联系。
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Trajectory in obsessive-compulsive disorder comorbidities.伴发于强迫症的轨迹。
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Biol Psychiatry. 2013 Jan 1;73(1):24-31. doi: 10.1016/j.biopsych.2012.06.023. Epub 2012 Jul 24.
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Guanfacine for the treatment of cognitive disorders: a century of discoveries at Yale.胍法辛治疗认知障碍:耶鲁百年探索。
Yale J Biol Med. 2012 Mar;85(1):45-58. Epub 2012 Mar 29.
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Neurobiological circuits regulating attention, cognitive control, motivation, and emotion: disruptions in neurodevelopmental psychiatric disorders.调控注意力、认知控制、动机和情绪的神经生物学回路:神经发育性精神障碍中的失调。
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