Scahill L, Riddle M A, King R A, Hardin M T, Rasmusson A, Makuch R W, Leckman J F
Yale Child Study Center, New Haven, Connecticut, USA.
J Child Adolesc Psychopharmacol. 1997 Summer;7(2):75-85. doi: 10.1089/cap.1997.7.75.
To evaluate the efficacy of fluoxetine in the treatment of tics and obsessive-compulsive symptoms in patients with Tourette's syndrome (TS), 14 subjects (8-33 years old) with TS participated in a 20-week, fixed-dose (20 mg daily), double-blind, placebo-controlled crossover trial of fluoxetine monotherapy. Five subjects met criteria for obsessive-compulsive disorder (OCD), 6 additional subjects had obsessive-compulsive features, and 3 subjects had TS without obsessive-compulsive symptoms. There was no improvement in tics after 8 weeks of treatment with fluoxetine (p = 0.58). In contrast, fluoxetine treatment was associated with a significant reduction in obsessive-compulsive symptoms for the group of 6 subjects initially randomized to fluoxetine (p = 0.04). Crossover analysis showed that fluoxetine had no marked effect on tics (n = 10, p = 0.30, but produced a modest decrease in obsessive-compulsive symptoms (n = 8, p = 0.06). Order effects and carry-over effects were not significant. Withdrawal to placebo was associated with a 55% increase in obsessive-compulsive symptoms (p = 0.05), but there was no effect on tics. The most common side effect was transient behavioral activation, which occurred in about half of the subjects and was more common in children. Fluoxetine may be useful for the treatment of obsessive-compulsive symptoms in some patients with TS, but does not appear to be effective for tics.
为评估氟西汀治疗抽动秽语综合征（TS）患者抽动症状及强迫症状的疗效，14名年龄在8至33岁的TS患者参与了一项为期20周的氟西汀单药固定剂量（每日20毫克）、双盲、安慰剂对照交叉试验。5名患者符合强迫症（OCD）标准，另外6名患者有强迫特征，3名患者有TS但无强迫症状。氟西汀治疗8周后抽动症状无改善（p = 0.58）。相比之下，对于最初随机分配接受氟西汀治疗的6名患者，氟西汀治疗与强迫症状显著减轻相关（p = 0.04）。交叉分析显示，氟西汀对抽动症状无明显影响（n = 10，p = 0.30），但使强迫症状略有减轻（n = 8，p = 0.06）。顺序效应和残留效应不显著。撤药至安慰剂组与强迫症状增加55%相关（p = 0.05），但对抽动症状无影响。最常见的副作用是短暂的行为激活，约一半的患者出现，在儿童中更常见。氟西汀可能对部分TS患者的强迫症状治疗有用，但对抽动症状似乎无效。
