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高剂量依他普仑治疗伴有强迫症的精神分裂症患者的疗效:一项开放标签研究。

The effectiveness of high-dose escitalopram in the treatment of patients suffering from schizophrenia with comorbid obsessive-compulsive disorder: an open-label study.

机构信息

Beer-Yaacov - Ness-Ziona Mental Health Center.

Abarbanel Mental Health Center, Bat-Yam.

出版信息

Int Clin Psychopharmacol. 2019 Jul;34(4):179-183. doi: 10.1097/YIC.0000000000000266.

Abstract

Obsessive-compulsive disorder frequently co-occur with schizophrenia causing a significant impairment. There is a paucity of published data on the treatment of such complicated patients. It has been suggested that the combination of antipsychotics and antiobsessive agents is the best treatment for schizophrenia with obsessive-compulsive disorder; however, there is no published data regarding the use of high dose (up to 40 mg/day) escitalopram. This open-label, prospective study was designed to investigate the efficacy, short-term safety and tolerability of escitalopram in doses up to 40 mg in patients with schizophrenia and obsessive-compulsive disorder. Patients were treated with increasing doses of escitalopram for 13 weeks. Thirteen patients (86.67%) completed the study. A significant improvement was observed in the total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores and in the scores of Y-BOCS-Obsession and Y-BOCS-Compulsion subscales. Furthermore, a significant improvement was observed in the total scores of the Positive and Negative Syndrome Scale and Clinical Global Impression-severity scale. Escitalopram, up to 40 mg/day was well tolerated and may be beneficial in the management of patients with schizophrenia and obsessive-compulsive disorder. Further studies are needed to confirm this finding and to assess long-term safety.

摘要

强迫症经常与精神分裂症共病,导致显著的功能损害。关于此类复杂患者的治疗方法,发表的数据很少。有人认为,联合使用抗精神病药和抗强迫症药物是治疗伴有强迫症的精神分裂症的最佳方法;然而,目前尚无关于使用高剂量(高达 40 毫克/天)艾司西酞普兰的相关数据。本开放性、前瞻性研究旨在评估高剂量(高达 40 毫克/天)艾司西酞普兰治疗伴有强迫症的精神分裂症患者的疗效、短期安全性和耐受性。患者接受艾司西酞普兰递增剂量治疗 13 周。共有 13 名患者(86.67%)完成了这项研究。耶鲁-布朗强迫量表(Y-BOCS)总分以及强迫和强迫观念分量表的评分均显著改善。阳性和阴性症状量表(PANSS)以及临床总体印象-严重度量表(CGI-S)总分也显著改善。艾司西酞普兰最高剂量达 40 毫克/天,耐受性良好,可能有助于伴有强迫症的精神分裂症患者的治疗。需要进一步的研究来证实这一发现,并评估长期安全性。

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