Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Clinical Psychology Course, Department of Psycho-Social Studies, School of Arts and Letters, Meiji University, Tokyo, Japan.
Neuropsychopharmacol Rep. 2023 Sep;43(3):320-327. doi: 10.1002/npr2.12364. Epub 2023 Jul 18.
Previous behavioral pharmacology studies involving rodents suggested riluzole had potential to be an ideal psychotropic drug for psychiatric disorders with anxiety or fear as primary symptoms. Several clinical studies have recently been conducted. The purpose of this study was to gather information about the efficacy and tolerability of riluzole for patients with those symptoms.
We searched PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane database from inception until April 2021, and performed manual searches for additional relevant articles. This review included: (1) studies involving participants that were patients with generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), acute stress disorder, or phobias; and (2) randomized controlled trials (RCTs) or intervention studies (e.g., single arm trials) examining the effects and safety of riluzole.
Of the 795 identified articles, four RCTs, one RCT subgroup-analysis, and three open-label trials without control groups met the inclusion criteria. Most trials evaluated the efficacy of riluzole as an augmentation therapy with selective serotonin reuptake inhibitors and other antidepressants for PTSD, OCD, or GAD. However, there was insufficient evidence to confirm the effects of riluzole for patients with these psychiatric disorders. Most trials demonstrated adequate study quality.
This review found insufficient evidence to confirm the effects of riluzole for psychiatric disorders with anxiety or fear as primary symptoms. It would be worthwhile to conduct studies that incorporate novel perspectives, such as examining the efficacy of riluzole as a concomitant medication for psychotherapy.
先前涉及啮齿动物的行为药理学研究表明,利鲁唑有可能成为一种理想的精神药物,适用于以焦虑或恐惧为主要症状的精神障碍。最近进行了几项临床研究。本研究的目的是收集有关利鲁唑治疗这些症状患者的疗效和耐受性的信息。
我们从建库开始至 2021 年 4 月在 PubMed、PsycINFO、CINAHL、EMBASE 和 Cochrane 数据库中进行了检索,并进行了额外相关文章的手工检索。本综述包括:(1)纳入参与者为广泛性焦虑障碍(GAD)、社交焦虑障碍、惊恐障碍、强迫症(OCD)、创伤后应激障碍(PTSD)、急性应激障碍或恐惧症患者的研究;(2)评估利鲁唑疗效和安全性的随机对照试验(RCT)或干预研究(如单臂试验)。
在 795 篇确定的文章中,有 4 项 RCT、1 项 RCT 亚组分析和 3 项无对照组的开放标签试验符合纳入标准。大多数试验评估了利鲁唑作为增效疗法与选择性 5-羟色胺再摄取抑制剂和其他抗抑郁药联合治疗 PTSD、OCD 或 GAD 的疗效。然而,尚无充分证据证实利鲁唑对这些精神障碍患者的疗效。大多数试验显示出较高的研究质量。
本综述发现,尚无充分证据证实利鲁唑对以焦虑或恐惧为主要症状的精神障碍的疗效。值得开展一些新的研究视角,例如,研究利鲁唑作为心理治疗伴随药物的疗效。