Mundo E, Guglielmo E, Bellodi L
Department of Neuropsychiatric Sciences, San Raffaele Hospital, School of Medicine, University of Milan, Italy.
Int Clin Psychopharmacol. 1998 Sep;13(5):219-24. doi: 10.1097/00004850-199809000-00005.
On the basis of recent results indicating that adjuvant pindolol has the positive effect of shortening latency to antidepressant response to selective serotonin reuptake inhibitors, the primary aim of our study was to evaluate the effect of pindolol on latency to antiobsessional response to fluvoxamine. Fifteen non-depressed obsessive-compulsive inpatients (six men and nine women) were consecutively recruited and randomly assigned to an 8-week standardized double-blind treatment with fluvoxamine and pindolol (group A) or fluvoxamine and placebo (group B). Patients were assessed weekly using rating scales for obsessive-compulsive disorder [Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), National Institute of Mental Health Obsessive-Compulsive Scale], co-occurent depressive symptoms (Hamilton Depression Scale) and global function (Clinical Global Improvement), from baseline to the end of the study. In accordance with data from the literature, response to treatment was defined as a reduction in YBOCS total scores of > or = 35% and a score on the 'global improvement' item of the Clinical Global Improvement of < 3. Data were analysed using analyses of variance with repeated measures performed on YBOCS and Hamilton Depression Scale scores to evaluate the mean quantitative response within and between groups and, additionally, employing a survival analysis to compute the percentage of responders within each group. Neither quantitative nor qualitative analysis revealed any differences between the two treatment groups, and pindolol did not shorten the latency of antiobsessional response to fluvoxamine. The results of this preliminary study indicate that different biological mechanisms underly the antiobsessional and antidepressant responses to fluvoxamine.
基于近期结果表明阿普洛尔辅助用药具有缩短选择性5-羟色胺再摄取抑制剂抗抑郁反应潜伏期的积极作用,我们研究的主要目的是评估阿普洛尔对氟伏沙明抗强迫反应潜伏期的影响。连续招募了15名无抑郁症状的强迫症住院患者(6名男性和9名女性),并随机分配至接受氟伏沙明与阿普洛尔的8周标准化双盲治疗组(A组)或氟伏沙明与安慰剂治疗组(B组)。从基线至研究结束,每周使用强迫症评定量表[耶鲁-布朗强迫症量表(Y-BOCS)、美国国立精神卫生研究所强迫症量表]、共病抑郁症状评定量表(汉密尔顿抑郁量表)和整体功能评定量表(临床总体印象量表)对患者进行评估。根据文献数据,治疗反应定义为Y-BOCS总分降低≥35%,且临床总体印象量表“整体改善”项目得分<3分。使用方差分析对Y-BOCS和汉密尔顿抑郁量表评分进行重复测量,以评估组内和组间的平均定量反应,并另外采用生存分析计算每组中反应者的百分比。定量分析和定性分析均未显示两个治疗组之间存在任何差异,阿普洛尔未缩短氟伏沙明抗强迫反应的潜伏期。这项初步研究结果表明,氟伏沙明的抗强迫和抗抑郁反应存在不同的生物学机制。