Kim David D, Barr Alasdair M, Stewart S Evelyn, White Randall F, Honer William G, Procyshyn Ric M
Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Mental Health & Substance Use Services Research Institute, Canada.
British Columbia Mental Health & Substance Use Services Research Institute, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
Med Hypotheses. 2021 Mar;148:110506. doi: 10.1016/j.mehy.2021.110506. Epub 2021 Jan 21.
Evidence supports the fact that clozapine can induce stressful obsessive-compulsive symptoms (OCS). Although clozapine's robust inhibition of serotonergic neurotransmission is believed to be a key mechanism underlying clozapine-induced OCS, the exact mechanism(s) are not fully understood. Intuitively, it is reasonable to believe that the dose of clozapine is likely related to emergent OCS severity. However, there is conflicting evidence where both positive and inverse relationships have been demonstrated between clozapine dose and emergent OCS severity. Upon examination of clozapine's receptor profile, in particular its affinity for 5-HT and D receptors, we hypothesize that there is a biphasic relationship between clozapine dose and emergent OCS severity. We present here a preliminary analysis of published cases in the literature to support our hypothesis.
有证据支持氯氮平可诱发应激性强迫症状（OCS）这一事实。虽然氯氮平对血清素能神经传递的强烈抑制作用被认为是氯氮平诱发OCS的关键机制，但其确切机制尚未完全明确。直观地说，有理由相信氯氮平的剂量可能与新发OCS的严重程度相关。然而，有相互矛盾的证据表明氯氮平剂量与新发OCS严重程度之间既存在正相关关系，也存在负相关关系。在研究氯氮平的受体谱，特别是其对5-羟色胺（5-HT）和多巴胺（D）受体的亲和力后，我们推测氯氮平剂量与新发OCS严重程度之间存在双相关系。我们在此展示对文献中已发表病例的初步分析以支持我们的假设。
