a Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry , University of Pisa , Pisa , Italy.
Expert Opin Drug Metab Toxicol. 2019 Apr;15(4):261-273. doi: 10.1080/17425255.2019.1584611. Epub 2019 Mar 8.
Although the treatment of obsessive-compulsive disorder (OCD), a common, chronic, and disabling psychiatric condition, has significantly improved in the last decades, with the demonstration of the specific effectiveness of serotonin reuptake inhibitors (SRIs), a large proportion of patients still show high relapse rates. In addition, pharmacological treatments should be maintained for years, so that the clinicians should take into account the pharmacokinetic changes in the long-term, which may be responsible for dangerous side effects or interactions. Areas covered: The aim of this paper was to review the literature on the pharmacokinetics of SSRIs and clomipramine, and on their pharmacokinetic parameters in OCD patients. Expert opinion: Although the literature on the pharmacokinetics of both clomipramine and SSRIs is consistent, data on pharmacokinetic parameters in OCD patients are very few. Given the impact of OCD, its chronicity requiring long-term treatments, together with the need to increase the clinical response rate, more studies in this field are urgently required.
尽管强迫症(OCD)的治疗在过去几十年中得到了显著改善,证明了 5-羟色胺再摄取抑制剂(SSRIs)的特殊疗效,但仍有很大一部分患者表现出高复发率。此外,药物治疗应持续多年,因此临床医生应考虑长期的药代动力学变化,这可能导致危险的副作用或相互作用。
本文旨在回顾 SSRIs 和氯米帕明的药代动力学以及 OCD 患者的药代动力学参数方面的文献。
尽管关于氯米帕明和 SSRIs 的药代动力学的文献是一致的,但 OCD 患者药代动力学参数的数据非常少。鉴于 OCD 的影响及其需要长期治疗的慢性,以及需要提高临床反应率,因此迫切需要在这一领域开展更多的研究。