Tural Ümit, Çorapçıoğlu Aytül, Boşgelmez Şükriye, Köroğlu Gültürk, Ünver Hatice, Duman Can, Önder Emin
Department of Psychiatry, The Nathan S. Kline Psychiatric Research Institute, Orangeburg, New York, USA.
Psychiatr Danub. 2019 Mar;31(1):69-77. doi: 10.24869/psyd.2019.69.
Folate is important for the synthesis of serotonin the neurotransmitter which plays a main role in OCD. We, therefore, explored the efficacy of folic acid as add on treatment to fluoxetine in a double blind study among patients with OCD.
A double blind, 12-week study comparing the efficacy of folic acid as add on treatment and placebo in patients with OCD was conducted on thirty six (36) patients. Patients were randomly assigned to folic acid (5 mg/day) or placebo group in addition to fluoxetine (40 mg/day). After the baseline assessment, on week 2, 4, 6, 8 and 12 assessments were performed by using YBOCS, HAM-D, HAM-A and CGI-S. Serum folate, erythrocyte folate, serum homocysteine and B levels were measured both baseline and the end of study.
A mixed model repeated measures ANCOVA on Y-BOCS scores were used to determine the difference between folic acid and placebo groups. No significant differences were found in the ratios of gender or in the mean age, serum folic acid level, erythrocyte folate level, serum homocysteine level and serum B level between the treatment groups at the baseline. Consecutively scores collected over six measurements on YBOCS, HAM-D, HAM-A and CGI showed non-significant differences between folic acid and placebo groups.
None of the biological markers of one carbon metabolism were associated with the change in YBOCS scores. It may be assumed that there is no beneficial effect of folic acid addition to fluoxetine in the treatment of OCD.
叶酸对于血清素的合成很重要,血清素作为一种神经递质,在强迫症中起主要作用。因此,我们在一项针对强迫症患者的双盲研究中,探讨了叶酸作为氟西汀辅助治疗的疗效。
对三十六(36)名患者进行了一项为期12周的双盲研究,比较叶酸作为辅助治疗和安慰剂对强迫症患者的疗效。除氟西汀(40毫克/天)外,患者被随机分配到叶酸组(5毫克/天)或安慰剂组。在基线评估后,于第2、4、6、8和12周使用耶鲁布朗强迫症量表(YBOCS)、汉密尔顿抑郁量表(HAM-D)、汉密尔顿焦虑量表(HAM-A)和临床总体印象量表(CGI-S)进行评估。在基线和研究结束时均测量血清叶酸、红细胞叶酸、血清同型半胱氨酸和B水平。
采用混合模型重复测量协方差分析YBOCS评分,以确定叶酸组和安慰剂组之间的差异。在基线时,治疗组之间在性别比例、平均年龄、血清叶酸水平、红细胞叶酸水平、血清同型半胱氨酸水平和血清B水平方面均未发现显著差异。在YBOCS、HAM-D、HAM-A和CGI上进行的六次测量所收集的连续评分显示,叶酸组和安慰剂组之间无显著差异。
一碳代谢的生物学标志物均与YBOCS评分的变化无关。可以假定,在强迫症治疗中,在氟西汀基础上加用叶酸没有有益效果。