Sallee F R, Koran L M, Pallanti S, Carson S W, Sethuraman G
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29403, USA.
Biol Psychiatry. 1998 Aug 1;44(3):220-7. doi: 10.1016/s0006-3223(97)00373-9.
Challenge with intravenous clomipramine (CMI) is serotonin selective and has been reported to transiently exacerbate symptoms in obsessive-compulsive disorder (OCD) patients, and to predict subsequent response to oral CMI therapy.
We administered CMI (12.5 mg, i.v.) to medication free OCD patients (N = 29) and normal controls (N = 22) to characterize neurohormonal response. A subset of OCD patients (26/29), was then treated with either pulse load i.v. or oral CMI followed by 8 weeks of oral CMI therapy.
In response to CMI challenge, OCD patients exhibit blunted cortisol and exaggerated growth hormone response relative to normal controls. OCD patients differ from controls in "sadness" ratings, with control exhibiting increased dysphoria in response to CMI. Growth hormone response to CMI challenge predicts treatment response (> or = 25% decreases YBOCS from baseline) to oral CMI at 8 weeks.
Growth hormone abnormalities associated with OCD in response to CMI challenge differentiates nonresponders after 8 weeks of oral CMI treatment from responders.
静脉注射氯米帕明（CMI）激发试验具有5-羟色胺选择性，据报道，该试验会使强迫症（OCD）患者的症状短暂加重，并能预测其随后对口服CMI治疗的反应。
我们对未服用药物的OCD患者（N = 29）和正常对照者（N = 22）静脉注射CMI（12.5 mg），以描述神经激素反应。然后，对一部分OCD患者（26/29）采用静脉脉冲负荷或口服CMI治疗，随后进行8周的口服CMI治疗。
与正常对照者相比，OCD患者在CMI激发试验中表现出皮质醇反应迟钝和生长激素反应增强。OCD患者与对照者在“悲伤”评分上存在差异，对照者在CMI激发试验中表现出烦躁不安增加。CMI激发试验中的生长激素反应可预测8周时口服CMI的治疗反应（Y-BOCS较基线下降≥25%）。
CMI激发试验中与OCD相关的生长激素异常可区分口服CMI治疗8周后的无反应者和有反应者。
