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使用选择性替代疗法治疗强迫症。

Use of Selective Alternative Therapies for Treatment of OCD.

作者信息

Khan Iman, Jaura Taimoor Asif, Tukruna Alaa, Arif Aabiya, Tebha Sameer Saleem, Nasir Sameen, Mukherjee Dattatreya, Masroor Nadia, Yosufi Abubakr

机构信息

Department of Medicine, Ziauddin Medical University, Karachi, Sindh, Pakistan.

General Adult Psychiatry, Southwest London and Saint George's Mental Health Nhs Trust, London, UK.

出版信息

Neuropsychiatr Dis Treat. 2023 Apr 5;19:721-732. doi: 10.2147/NDT.S403997. eCollection 2023.

Abstract

About 40% of the people with the obsessive-compulsive-disorder do not experience the desired outcome after the existing treatment, and its several side effects were reported. This systematic review was conducted to evaluate the efficacy and tolerability of alternative drugs and assess the possibility of their use as treatment options for obsessive-compulsive-disorder. The Scientific databases PubMed, Science Direct, Google Scholar, Cochrane, Directory of Open Access Journals, MedRxiv and BioRxiv, were searched from inception to March 2022, using appropriate search strategies for each drug and following the Prisma guidelines 2020. Studies were selected according to the already set criteria and assessed for bias. Data were extracted, and descriptive and continuous data were analyzed and presented as frequency/percentage and mean. A total of 16 observational and interventional studies were included for data extraction. The studies focused on four drugs, Psilocybin (n=4), Cannabis (n=7), Nicotine (n=3), and Morphine (n=2), that were used to test out their effect on OCD symptoms. Overall, the majority of the studies showed promising results by documenting a reduction in Y-BOCS scores. However, few subjects, specifically those using nicotine or Cannabis, did not affect their condition or self-reported worsening symptoms. Few side effects were also noticed. This systematic review found that the drugs mostly showed a positive response. All Psilocybin and morphine users, 88.2% and 74.1% of the nicotine and Cannabis users, respectively, reported experiencing the positive effect of these drugs, indicating that these drugs have the potential to be used in the management of OCD. However, further research is required in this arena to thoroughly understand the mechanism of action by which these drugs produce their therapeutic effect. Policies to destigmatize and encourage clinical trials with these drugs are crucial for exploring the use of these drugs as a treatment option for OCD.

摘要

约40%的强迫症患者在接受现有治疗后未取得预期效果,且有报道称现有治疗存在多种副作用。本系统评价旨在评估替代药物的疗效和耐受性,并评估其作为强迫症治疗选择的可能性。从创刊至2022年3月,使用针对每种药物的适当检索策略并遵循2020年Prisma指南,对科学数据库PubMed、Science Direct、谷歌学术、Cochrane、开放获取期刊目录、MedRxiv和BioRxiv进行了检索。根据既定标准选择研究并评估偏倚。提取数据,对描述性和连续性数据进行分析,并以频率/百分比和均值形式呈现。共纳入16项观察性和干预性研究进行数据提取。这些研究聚焦于四种药物,即裸盖菇素(n = 4)、大麻(n = 7)、尼古丁(n = 3)和吗啡(n = 2),用于测试它们对强迫症症状的影响。总体而言,大多数研究通过记录Y - BOCS评分的降低显示出有前景的结果。然而,少数受试者,特别是那些使用尼古丁或大麻的受试者,病情未得到改善或自我报告症状恶化。也观察到了少数副作用。本系统评价发现这些药物大多显示出阳性反应。所有裸盖菇素和吗啡使用者,以及分别88.2%的尼古丁使用者和74.1%的大麻使用者报告称体验到了这些药物的积极效果,表明这些药物有潜力用于强迫症的管理。然而,该领域需要进一步研究以彻底了解这些药物产生治疗效果的作用机制。消除对这些药物的污名化并鼓励开展相关临床试验的政策对于探索将这些药物用作强迫症的治疗选择至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4aef/10083036/c0d64252a518/NDT-19-721-g0001.jpg

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