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阿立哌唑与利培酮治疗双相情感障碍患者强迫症有效性的比较:双盲随机临床试验

Comparison of Aripiprazole and Risperidone effectiveness in treating obsessive-compulsive disorder in patients with bipolar disorder: Double-blind, randomized clinical trial.

作者信息

Khorshidian Faezeh, Hamidia Angela, Kheirkhah Farzan, Moghadamnia Ali Akbar, Bijani Ali, Mirtabar Seyedeh Mahbobeh, Koutanaei Sakineh Javadian

机构信息

Department of Psychiatry, School of Medicine, Health Research Institute Babol University of Medical Sciences Babol Iran.

Department of Pharmacology, School of Medicine, Health Research Institute Babol University of Medical Sciences Babol Iran.

出版信息

Health Sci Rep. 2023 Aug 27;6(8):e1531. doi: 10.1002/hsr2.1531. eCollection 2023 Aug.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) is a mental illness with a chronic coarse and waxing and waning of symptoms. Treatment of OCD in patients with bipolar disorder (BD) remains challenging.

OBJECTIVES

The present study aims to compare the safety and effectiveness of Risperidone and Aripiprazole as adjunctive therapy with valproate sodium, in treating mania, depression, and OCD in patients with comorbidity of OCD-BD.

METHODS

This research is 3 phase, double-blind, randomized clinical trial, with a total number of 64 patients. The diagnostic psychiatrist clinical interview was based on diagnostic and statistical manual of mental disorders, 5th edition (DSM-5) criteria. For assessing severity of OCD, mania, and depression, Yale-Brown obsessive-compulsive scale (Y-BOCS), young mania rating scale (YMRS), and Hamilton depression rating scale (HAM-D) scores were used. Patients were randomly assigned to the two parallel groups. All patients in both group were received valproate sodium, one group was treated with Aripiprazole and the other group was treated with Risperidon as adjective therapy with valproate sodium.The SPSS software (version 22),  test, -test, and analysis of variance with repeated measures were used to analyze the data.

RESULTS

The dosage and time of both drugs were statistically significant in reducing the mean score of all three mentioned scales, but the effect of group was not statistically significant in HAM-D and YMRS scores, only in terms of OCD, the mean of the Y-BOCS score was significantly lower in the Aripiprazole group ( < 0.001). In relation to side effects, Risperidone induced statistically significant weight gain ( < 0.001) and Aripiprazole induced statistically significant sleep disturbance ( < 0.05).

CONCLUSIONS

Both Aripiprazole and Risperidone can be used effectively as adjunctive therapy with valproate sodium in treating OCD in patients with BD without any serious and life threatening adverse effect. Aripiprazole is more effective than Risperidone in treating OCD in BD.

摘要

背景

强迫症(OCD)是一种症状呈慢性、时好时坏的精神疾病。双相情感障碍(BD)患者的强迫症治疗仍然具有挑战性。

目的

本研究旨在比较利培酮和阿立哌唑作为丙戊酸钠辅助治疗药物,在治疗强迫症合并双相情感障碍患者的躁狂、抑郁和强迫症方面的安全性和有效性。

方法

本研究为3期双盲随机临床试验,共64例患者。诊断性精神科医生临床访谈依据《精神障碍诊断与统计手册》第5版(DSM-5)标准。为评估强迫症、躁狂和抑郁的严重程度,使用了耶鲁-布朗强迫症量表(Y-BOCS)、青年躁狂评定量表(YMRS)和汉密尔顿抑郁评定量表(HAM-D)得分。患者被随机分配到两个平行组。两组所有患者均接受丙戊酸钠治疗,一组用阿立哌唑治疗,另一组用利培酮作为丙戊酸钠的辅助治疗。使用SPSS软件(版本22)、检验、t检验和重复测量方差分析来分析数据。

结果

两种药物的剂量和用药时间在降低上述三个量表的平均分方面均具有统计学意义,但组间效应在HAM-D和YMRS得分上无统计学意义,仅在强迫症方面,阿立哌唑组的Y-BOCS平均分显著更低(P<0.001)。在副作用方面,利培酮导致具有统计学意义的体重增加(P<0.001),阿立哌唑导致具有统计学意义的睡眠障碍(P<0.05)。

结论

阿立哌唑和利培酮均可有效作为丙戊酸钠的辅助治疗药物,用于治疗双相情感障碍患者的强迫症,且无任何严重及危及生命的不良反应。在治疗双相情感障碍合并的强迫症方面,阿立哌唑比利培酮更有效。

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本文引用的文献

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Neuron. 2019 Apr 3;102(1):27-47. doi: 10.1016/j.neuron.2019.01.046.
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