Paroxetine treatment of episodic rages associated with Tourette's disorder.
Paroxetine treatment of episodic rages associated with Tourette's disorder.
复制标题
帕罗西汀治疗与妥瑞氏症相关的阵发性愤怒。
DOI：
10.4088/jcp.v59n1104
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
C. Budman
中科院分区：
文献类型：
--
作者：
R. Bruun;C. Budman
背景
据估计，多达30%的抽动秽语综合征（抽动秽语障碍）患者会发生发作性暴怒，但其治疗从未进行过系统研究。我们报告的结果，开放标签试点研究使用帕罗西汀治疗抽动秽语障碍相关的愤怒发作。
方法
45名抽动秽语综合征/愤怒患者（DSM-IV）接受了帕罗西汀治疗，特别是为了控制他们的愤怒。其他症状，如抽搐，注意力缺陷/多动障碍（ADHD）和强迫症（OCD）不是本研究的目标。当患者报告的愤怒症状减少75%或更多，并且在作者设计的4分量表上频率减少至少1分时，治疗被认为是治疗性的。
结果
在帕罗西汀治疗8周后，29名患者（占完成研究的76%）报告说，愤怒明显减少或完全消失。9名患者报告愤怒无显著变化。7名患者没有完成研究（3名由于副作用，4名愤怒频率增加）。帕罗西汀的平均剂量为33 mg/天;最小有效剂量为15 mg/天。
结论
我们无法确定任何因素，显着改变帕罗西汀治疗抽动秽语障碍相关的愤怒发作的疗效。绝大多数（87%）的患者除了抽动秽语障碍外，还患有多动症和强迫症。年龄、性别和合并使用其他药物在治疗结果方面无显著差异。结果表明，帕罗西汀可能在临床治疗抽动秽语障碍患者的发作性愤怒中发挥重要作用。
BACKGROUND
Episodic rages have been estimated to occur in as many as 30% of patients with Tourette's syndrome (Tourette's disorder), but their treatment has never been systematically investigated. We report on the results of an open-label pilot study using paroxetine for the treatment of Tourette's disorder-associated rage episodes.
METHOD
Forty-five Tourette's/rage patients (DSM-IV) were treated with paroxetine, specifically to control their rages. Other symptoms such as tics, attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) were not targeted by this study. Treatment was deemed to be therapeutic when rage symptoms were diminished by 75% or more by patient report and were diminished in frequency by at least 1 point on a 4-point scale devised by the authors.
RESULTS
After 8 weeks on paroxetine treatment, 29 patients (76% of those who completed the study) reported that rages were significantly diminished or completely absent. Nine patients reported no significant change in rages. Seven patients did not complete the study (3 because of side effects and 4 whose rage frequency increased). The mean dose of paroxetine was 33 mg/day; minimum effective dose was 15 mg/day.
CONCLUSION
We were unable to determine any factors that significantly altered the efficacy of paroxetine for treatment of Tourette's disorder-associated rage episodes. The great majority (87%) of the patients had both ADHD and OCD in addition to Tourette's disorder. The age, sex, and concomitant use of other medications revealed no significant differences in treatment outcome. The results suggest that paroxetine may have an important role in the clinical treatment of episodic rages in Tourette's disorder patients.