McDougle C J, Goodman W K, Leckman J F, Price L H
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Psychiatr Clin North Am. 1993 Dec;16(4):749-66.
Recent advances in the pharmacotherapy of obsessive compulsive disorder (OCD) have led to a significant reduction in suffering and a return to productive living for many patients previously considered refractory to treatment. Potent inhibitors of 5-hydroxytryptamine (5-HT) re-uptake clearly have been established as the first-line pharmacotherapy for treatment of OCD. The addition of agents that enhance 5-HT neurotransmission to ongoing treatment in patients whose OCD is refractory to 5-HT re-uptake inhibitors has not yielded impressive results. The addition of dopamine (DA) antagonists to the regimens of treatment-resistant patients appears to be a potentially useful strategy for the specific subgroup of OCD patients with a comorbid chronic tic disorder such as Tourette's syndrome. Pharmacologic studies suggest that both the 5-HT and DA systems may be critical to the treatment and possibly the pathophysiology of OCD.
强迫症（OCD）药物治疗的最新进展已使许多先前被认为难治的患者痛苦显著减轻，并回归到有意义的生活。5-羟色胺（5-HT）再摄取强效抑制剂已明确成为治疗强迫症的一线药物疗法。对于强迫症对5-HT再摄取抑制剂难治的患者，在持续治疗中添加增强5-HT神经传递的药物并未产生令人瞩目的效果。对于患有共病慢性抽动障碍（如妥瑞氏综合征）的特定强迫症患者亚组，在难治性患者的治疗方案中添加多巴胺（DA）拮抗剂似乎是一种潜在有用的策略。药理学研究表明，5-HT和DA系统可能对强迫症的治疗以及可能的病理生理学都至关重要。
