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评估维生素B12和叶酸补充剂对强迫症缺乏症患者的治疗效果:一项对比分析。

Evaluating Treatment Outcomes of Vitamin B12 and Folic Acid Supplementation in Obsessive-Compulsive Disorder Patients With Deficiencies: A Comparative Analysis.

作者信息

Algin Sultana, Ahmed Tanbir, Reza Md Munaim, Akter Asha, Tanzilla Nusrat Jahan, Haq Md Ahsanul, Ahmad Rahnuma, Mehta Miral, Haque Mainul

机构信息

Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD.

Department of Psychiatry, Enam Medical College and Hospital, Savar, BGD.

出版信息

Cureus. 2025 Apr 17;17(4):e82420. doi: 10.7759/cureus.82420. eCollection 2025 Apr.

Abstract

Introduction Obsessive-compulsive disorder (OCD) imposes a considerable impact on day-to-day functioning. Many people experience insufficient symptom relief even after taking the optimum dose of OCD medications. Reduced levels of folic acid and vitamin B₁₂, along with elevated homocysteine (HCY), have been suggested as possible factors in the persistence of obsessive-compulsive (OC) symptoms. This study investigated how supplementation of vitamin B₁₂, folic acid, and selective serotonin reuptake inhibitors (SSRIs) affects OC symptoms and related biochemical markers. Methods A comparative study enrolled 72 OCD patients. For eight weeks, the conventional treatment group received SSRIs or other anti-obsessive medication. In contrast, the nutrient-supplemented group received supplements of vitamin B₁₂, folic acid, and SSRIs. Micronutrients HCY, folic acid, and vitamin B₁₂ were measured at baseline and after eight weeks. Besides, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was applied to assess the severity of OCD symptoms at the baseline, four-week, and eight-week visits. Results Group A (conventional treatment with nutrient supplement) showed significant improvements in vitamin B₁₂, blood folic acid, and reductions in HCY levels compared to Group B (conventional treatment). However, no substantial differences in insight levels were observed between the groups. Both groups exhibited decreased Y-BOCS scores, indicating a reduction in OCD symptoms; however, the improvements in Group A (conventional treatment + nutrient supplement) were statistically significant. Conclusions When taken with SSRIs, vitamin B₁₂and folic acid supplements seem to improve OCD patients' clinical results. These results imply that this supplementation could be a useful therapeutic adjunct.

摘要

引言

强迫症(OCD)对日常功能有相当大的影响。许多人即使服用了最佳剂量的强迫症药物,症状缓解仍不充分。叶酸和维生素B₁₂水平降低,以及同型半胱氨酸(HCY)升高,被认为可能是强迫症(OC)症状持续存在的因素。本研究调查了补充维生素B₁₂、叶酸和选择性5-羟色胺再摄取抑制剂(SSRI)如何影响OC症状及相关生化指标。

方法

一项对比研究纳入了72名强迫症患者。在八周时间里,传统治疗组接受SSRI或其他抗强迫药物治疗。相比之下,营养补充组接受维生素B₁₂、叶酸和SSRI补充剂。在基线和八周后测量微量营养素HCY、叶酸和维生素B₁₂。此外,应用耶鲁-布朗强迫症量表(Y-BOCS)在基线、四周和八周就诊时评估强迫症症状的严重程度。

结果

与B组(传统治疗)相比,A组(传统治疗加营养补充)在维生素B₁₂、血叶酸水平上有显著改善,HCY水平降低。然而,两组在洞察力水平上未观察到实质性差异。两组的Y-BOCS评分均降低,表明强迫症症状减轻;然而,A组(传统治疗+营养补充)的改善具有统计学意义。

结论

当与SSRI一起服用时,维生素B₁₂和叶酸补充剂似乎能改善强迫症患者的临床疗效。这些结果表明这种补充可能是一种有用的治疗辅助手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d7/12004335/8af19b7bb1a0/cureus-0017-00000082420-i01.jpg

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