Di Salvo Gabriele, Maina Giuseppe, Pessina Enrico, Teobaldi Elena, Barbaro Francesca, Martini Azzurra, Albert Umberto, Rosso Gianluca
Department of Neurosciences "Rita Levi Montalcini", University of Turin, 10126 Turin, Italy.
Psychiatric Unit, San Luigi Gonzaga University Hospital, 10126 Turin, Italy.
Medicina (Kaunas). 2020 Dec 24;57(1):9. doi: 10.3390/medicina57010009.
: Aripiprazole is a first-line agent in the treatment of bipolar disorder (BD) and available data demonstrates its efficacy on clinical symptoms in serotonin reuptake inhibitors-resistant obsessive-compulsive disorder (OCD) patients. Therefore, aripiprazole augmentation to mood stabilizers could represent a promising treatment in BD patients with comorbid OCD. The study examined the efficacy and safety of aripiprazole added to lithium or valproate for the treatment of obsessive-compulsive (OC) symptoms in euthymic BD patients with comorbid OCD. : This is a 12-week prospective observational study. The efficacy of aripiprazole on OC symptoms was assessed through the mean change of Yale-Brown Obsessive-Compulsive (YBOCS) total score. Tolerability was assessed with the Utvalg for Kliniske Undersogelser (UKU) side effect scale and by reporting adverse events. : A total of 70 patients were included in the analyses. The withdrawal rate was 21.4%, mainly due to adverse events. Mean ± SD final aripiprazole dose was 15.2 ± 5.3 in the completer sample ( = 55). The Y-BOCS mean score decreased from 24.0 ± 4.1 at baseline to 17.1 ± 4.3 at 12 weeks. Treatment response rate (Y-BOCS reduction ≥ 35%) was 41.8%, while partial response rate (Y-BOCS reduction greater than 25% but less than 35% from baseline) accounted for the other 18.2% of patients. Overall, 91.4% of completers had at least 1 adverse effect (tremor, tension/inner unrest, reduced duration of sleep, akathisia). No significant differences emerged comparing aripiprazole efficacy and tolerability between patients treated with lithium or valproate. : Our findings show that aripiprazole addition to lithium or valproate can reduce OC symptoms in real-world BD euthymic patients.
阿立哌唑是治疗双相情感障碍（BD）的一线药物，现有数据表明其对血清素再摄取抑制剂耐药的强迫症（OCD）患者的临床症状有效。因此，在双相情感障碍合并强迫症的患者中，将阿立哌唑添加到心境稳定剂中可能是一种有前景的治疗方法。该研究考察了在双相情感障碍合并强迫症的心境正常患者中，添加阿立哌唑至锂盐或丙戊酸盐治疗强迫症状的疗效和安全性。 ：这是一项为期12周的前瞻性观察研究。通过耶鲁-布朗强迫症量表（YBOCS）总分的平均变化来评估阿立哌唑对强迫症状的疗效。使用临床研究不良反应量表（UKU）和报告不良事件来评估耐受性。 ：共有70名患者纳入分析。脱落率为21.4%，主要原因是不良事件。在完成研究的样本（n = 55）中，阿立哌唑最终平均剂量±标准差为15.2±5.3。YBOCS平均评分从基线时的24.0±4.1降至12周时的17.1±4.3。治疗有效率（YBOCS评分降低≥35%）为41.8%，而部分有效率（YBOCS评分较基线降低大于25%但小于35%）占其余18.2%的患者。总体而言，91.4%的完成研究患者至少出现1种不良反应（震颤、紧张/内心不安、睡眠时间缩短、静坐不能）。在接受锂盐或丙戊酸盐治疗的患者之间，比较阿立哌唑的疗效和耐受性时未发现显著差异。 ：我们的研究结果表明，在锂盐或丙戊酸盐基础上加用阿立哌唑可减轻双相情感障碍心境正常的现实世界患者的强迫症状。
