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.
Pharmacopsychiatry. 2018 Nov;51(6):263-269. doi: 10.1055/s-0043-120268. Epub 2017 Nov 3.
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.
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).
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.
Memantine is an effective and well-tolerated augmentation in severe OCD patients refractory to SRI monotherapy.
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。
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。
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。
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。