Jackson C W, Morton W A, Lydiard R B
Department of Hospital Pharmacy Practice and Administration, Medical University of South Carolina, Charleston 29425.
South Med J. 1994 Mar;87(3):310-21. doi: 10.1097/00007611-199403000-00003.
Obsessive-compulsive disorder (OCD) is an intriguing, difficult problem characterized by anxiety-producing intrusive thoughts and performance of anxiety-reducing rituals. Current evidence suggests that OCD may be associated with dysregulation of serotonin and dopamine neurotransmission. Numerous early studies involving the serotonin-specific reuptake inhibitor clomipramine led to the formulation of this hypothesis. Positive results with clomipramine initiated further research with other serotonin-specific reuptake inhibitors, such as fluoxetine, fluvoxamine, sertraline, and serotonergic agents such as buspirone and trazodone. Findings from a number of clinical trials suggest that drugs that inhibit serotonin reuptake or affect serotonergic transmission in other ways are of clear benefit in the treatment of OCD. These drugs may be more effective for obsessive thoughts than for compulsive rituals. Effective pharmacotherapy can dramatically decrease obsessive-compulsive symptoms and improve the patient's quality of life.
强迫症（OCD）是一个引人关注且棘手的问题，其特征为产生焦虑的侵入性思维以及执行减轻焦虑的仪式行为。目前的证据表明，强迫症可能与血清素和多巴胺神经传递失调有关。众多涉及血清素特异性再摄取抑制剂氯米帕明的早期研究促成了这一假说的形成。氯米帕明的阳性结果引发了对其他血清素特异性再摄取抑制剂（如氟西汀、氟伏沙明、舍曲林）以及血清能药物（如丁螺环酮和曲唑酮）的进一步研究。多项临床试验的结果表明，抑制血清素再摄取或以其他方式影响血清能传递的药物在治疗强迫症方面具有明显益处。这些药物对强迫观念可能比对强迫仪式行为更有效。有效的药物治疗可显著减轻强迫症状并改善患者的生活质量。
