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美金刚增效治疗难治性强迫障碍:一项随机对照试验。

Memantine Augmentation Improves Symptoms in Serotonin Reuptake Inhibitor-Refractory Obsessive-Compulsive Disorder: A Randomized Controlled Trial.

机构信息

Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.

Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Pharmacopsychiatry. 2018 Nov;51(6):263-269. doi: 10.1055/s-0043-120268. Epub 2017 Nov 3.

Abstract

INTRODUCTION

There is a large body of evidence on the clinical benefits of augmentation therapy with glutamate-modulating agents, such as memantine in reducing OCD symptoms.

METHODS

A double-blind, placebo-controlled trial was conducted on SRIrefractory OCD patients. Thirty-two patients were randomized to receive either 20 mg/day memantine or placebo augmentation and were visited at baseline and every 4 weeks for 12 weeks. Results were measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

RESULTS

The Y-BOCS total score was significantly reduced in the memantine group at the end of weeks 8 and 12, while no improvement was observed in the placebo group throughout the trial. A reduction of 40.9% in the mean Y-BOCS total score by week 12 in the memantine group resulted in 73.3% of patients achieving treatment response. The findings showed that a time to effect of 8 weeks was necessary to observe significant improvement in OCD symptoms, while treatment response was only seen after 12 weeks of memantine augmentation.

DISCUSSION

Memantine is an effective and well-tolerated augmentation in severe OCD patients refractory to SRI monotherapy.

摘要

简介

有大量证据表明,谷氨酸调节药物(如美金刚)的增效治疗可显著改善强迫症(OCD)症状。

方法

对 SRI 难治性 OCD 患者进行了一项双盲、安慰剂对照试验。32 名患者被随机分为美金刚 20mg/天组或安慰剂增效组,并在基线和治疗的第 4、8、12 周进行访视。采用耶鲁-布朗强迫量表(Y-BOCS)评估结果。

结果

在第 8 周和第 12 周末,美金刚组的 Y-BOCS 总分显著降低,而安慰剂组在整个试验过程中均无改善。美金刚组在第 12 周时 Y-BOCS 总分平均降低 40.9%,导致 73.3%的患者达到治疗应答。结果表明,需要 8 周的时间才能观察到 OCD 症状的显著改善,而只有在美金刚增效治疗 12 周后才出现治疗应答。

讨论

美金刚是一种有效且耐受性良好的增效治疗药物,可用于治疗对 SRI 单药治疗难治的严重 OCD 患者。

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