Apter A, Ratzoni G, King R A, Weizman A, Iancu I, Binder M, Riddle M A
Department, Geha Hospital, Beilinson Medical Center, Petah Tikva, Israel.
J Am Acad Child Adolesc Psychiatry. 1994 Mar-Apr;33(3):342-8. doi: 10.1097/00004583-199403000-00007.
Fluvoxamine, a monocyclic, specific serotonin uptake inhibitor with demonstrated efficacy in obsessive-compulsive disorder (OCD) and depression in adults, is marketed in more than 30 countries worldwide, including Israel. In the United States, where fluvoxamine is available only on an investigational basis, marketing appears imminent. This study evaluates the safety and efficacy of fluvoxamine in adolescents.
In an 8-week, open-label trial of fluvoxamine, 20 adolescent inpatients, ages 13 to 18 years, were treated for OCD (n = 14) or major depressive disorder (MDD)(n = 6) with daily doses ranging from 100 to 300 mg. Target symptoms were rated at regular intervals with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS); Suicide Potential Scales (SPS); Beck Depression Inventory (BDI); the Overt Aggression Scale (OAS); and the Children's Global Adjustment Scale (CGAS).
Fluvoxamine proved relatively safe and was especially effective in the patients with OCD; mean Y-BOCS scores decreased significantly (p < .0001) from 28.0 to 19.8 on medication. Although fluvoxamine also appeared effective in decreasing depression and bulimic symptoms, its impact on impulsive, suicidal, and anorectic symptoms was less clear. The commonest side effects (n > or = 3) were dermatitis, insomnia, hyperactivity, excitement, anxiety, tremor, and nausea. Fluvoxamine was discontinued in four patients because of side effects; the most serious side effect occurred in two debilitated anorexic patients, of whom one became delirious and the other developed hallucinations.
Preliminary evidence suggests that short-term treatment of adolescents with fluvoxamine is relatively safe and may be effective for OCD and some affective spectrum symptoms.
氟伏沙明是一种单环特异性5-羟色胺摄取抑制剂，已证实对成人强迫症（OCD）和抑郁症有效，在全球30多个国家包括以色列上市。在美国，氟伏沙明仅在研究阶段可用，上市似乎指日可待。本研究评估氟伏沙明在青少年中的安全性和疗效。
在一项为期8周的氟伏沙明开放标签试验中，20名年龄在13至18岁的青少年住院患者接受了OCD（n = 14）或重度抑郁症（MDD）（n = 6）治疗，每日剂量为100至300毫克。使用耶鲁-布朗强迫症量表（Y-BOCS）、自杀潜力量表（SPS）、贝克抑郁量表（BDI）、公开攻击量表（OAS）和儿童总体适应量表（CGAS）定期对目标症状进行评分。
氟伏沙明相对安全，对OCD患者尤其有效；用药后Y-BOCS平均得分从28.0显著降至19.8（p <.0001）。虽然氟伏沙明在减轻抑郁和贪食症状方面似乎也有效，但其对冲动、自杀和厌食症状的影响尚不清楚。最常见的副作用（n≥3）是皮炎、失眠、多动、兴奋、焦虑、震颤和恶心。4名患者因副作用停用氟伏沙明；最严重的副作用发生在2名虚弱的厌食患者身上，其中1名出现谵妄，另1名出现幻觉。
初步证据表明，青少年短期使用氟伏沙明相对安全，可能对OCD和一些情感谱系症状有效。
