Kasvikis Y, Marks I M
Experimental Psychopathology Section, Institute of Psychiatry, London, UK.
Psychopharmacology (Berl). 1988;95(1):113-8. doi: 10.1007/BF00212778.
Forty-nine obsessive-compulsive ritualisers completed a double-blind controlled study of clomipramine and exposure therapy. More severely ill patients allowed higher doses of medication to be prescribed and had higher plasma levels of both clomipramine and desmethylclomipramine. Exposure instructions had a strong effect, whereas the clomipramine effect was small and short-lived. Plasma levels of desmethylclomipramine but not of clomipramine correlated with outcome at weeks 8 and 17. There was no evidence of a therapeutic window for either clomipramine or its metabolite. Patients' physical complaints before treatment correlated positively with depression and anxiety, especially sexual difficulties. Dry mouth, as a side effect, was most evidently related to clomipramine and its usefulness in monitoring drug compliance for patients on clomipramine is reaffirmed.
49名强迫性仪式行为患者完成了一项关于氯米帕明和暴露疗法的双盲对照研究。病情较重的患者允许开具更高剂量的药物，且氯米帕明和去甲氯米帕明的血浆水平更高。暴露指导有很强的效果，而氯米帕明的效果较小且持续时间短。在第8周和第17周时，去甲氯米帕明而非氯米帕明的血浆水平与治疗结果相关。没有证据表明氯米帕明或其代谢物存在治疗窗。治疗前患者的身体不适与抑郁和焦虑呈正相关，尤其是性功能障碍。口干作为一种副作用，与氯米帕明最为明显相关，再次证实了其在监测服用氯米帕明患者药物依从性方面的作用。
