Ravizza L, Barzega G, Bellino S, Bogetto F, Maina G
Department of Neuroscience, University of Turin, Italy.
Psychopharmacol Bull. 1996;32(4):677-82.
It has been well established that more than 40 percent of patients with obsessive-compulsive disorder (OCD) do not improve after an adequate trial with serotonin uptake inhibitors (SUIs). The first purpose of this trial was to compare the short-term efficacy and safety of two different strategies in a sample of treatment-refractory OCD patients: dose increase of the ongoing treatment versus the addition of another SUI. The second purpose was to investigate the short-term efficacy and safety of adjunctive risperidone in SUI-refractory OCD patients. Thirty-three OCD patients who were unimproved after a short-term treatment with clomipramine (150 mg/day) were admitted to the study. In the first part of the study, the dose increase of clomipramine was compared with sertraline addition, in an open-label manner. The addition of sertraline to the ongoing treatment appeared to be more effective and tolerable than the clomipramine dose increase. Seven (50%) of the 14 patients who were considered nonresponders after the first part of the study, showed good clinical improvement and good tolerability after risperidone augmentation. These results suggest that risperidone addition to ongoing SUIs may be useful in augmenting pharmacologic response in OCD.
已经充分证实，超过40%的强迫症（OCD）患者在足量试用5-羟色胺摄取抑制剂（SUIs）后并无改善。本试验的首要目的是在难治性OCD患者样本中比较两种不同策略的短期疗效和安全性：增加正在进行的治疗剂量与加用另一种SUIs。第二个目的是研究在SUIs难治性OCD患者中加用利培酮的短期疗效和安全性。33例在短期服用氯米帕明（150mg/天）后无改善的OCD患者被纳入研究。在研究的第一部分，以开放标签的方式比较了氯米帕明增加剂量与加用舍曲林的情况。在正在进行的治疗中加用舍曲林似乎比增加氯米帕明剂量更有效且耐受性更好。在研究第一部分被视为无反应者的14例患者中，7例（50%）在加用利培酮后临床有明显改善且耐受性良好。这些结果表明，在正在进行的SUIs治疗中加用利培酮可能有助于增强对OCD的药物反应。
