N-Acetylcysteine Add-On Treatment in Refractory Obsessive-Compulsive Disorder A Randomized, Double-Blind, Placebo-Controlled Trial
N-Acetylcysteine Add-On Treatment in Refractory Obsessive-Compulsive Disorder A Randomized, Double-Blind, Placebo-Controlled Trial
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DOI：
10.1097/jcp.0b013e318272677d
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发表时间：
2012-12-01
影响因子：
2.9
通讯作者：
Hafezian, Hasan
中科院分区：
文献类型：
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作者：
Afshar, Hamid;Roohafza, Hamidreza;Hafezian, Hasan
目的：本研究旨在评估N-乙酰半胱氨酸（一种谷氨酸调节剂）作为5-羟色胺再摄取抑制剂治疗难治性强迫症患者的辅助治疗的疗效和安全性。36名妇女;平均+/- SD年龄，30.93 +/- 4.99）与强迫症-对5-羟色胺再摄取抑制剂治疗无效的强迫症患者被随机分配到N-乙酰半胱氨酸（高达2400 mg/d）或安慰剂的12周干预期。主要观察指标为Yale-Brown强迫量表（Y-BOCS）评分从基线到终点的变化以及试验结束时各组的完全应答率。结果：Y-BOCS评分的变化随时间的推移（P < 0.001）和组间差异（P <0.001）。N-乙酰半胱氨酸分配的患者在研究终点时显示平均Y-BOCS评分（P = 0.003）和临床总体印象-疾病严重程度量表评分（P = 0.01）显著改善，但临床总体印象-改善量表评分无改善。在N-乙酰半胱氨酸组的患者中，52.6%的患者在研究结束时完全应答，这是显着高于安慰剂组的患者的15%（P = 0.013）。结论：本试验表明，N-乙酰半胱氨酸可能是一个安全和有效的选择，以加强标准治疗难治性强迫症患者。
Objective: This study aimed to evaluate the efficacy and safety of N-acetylcysteine, a glutamate-modulating agent, in patients with treatment-refractory obsessive-compulsive disorder as an adjunct to serotonin re-uptake inhibitor treatment.Methods: Forty-eight patients (36 women; mean +/- SD age, 30.93 +/- 4.99) with obsessive-compulsive disorder who failed to respond to a course of serotonin reuptake inhibitor treatment were randomized to a 12-week intervention period of N-acetylcysteine (up to 2400 mg/d) or placebo. Primary outcome measures were the change in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score from baseline to end point and the rate of full response in each group at the end of trial. Full response was defined as 35% or greater reduction in Y-BOCS score from baseline.Results: Changes of Y-BOCS score were different over time (P < 0.001) and between groups (P < 0.001). N-acetylcysteine-assigned patients showed significantly improved mean Y-BOCS score (P = 0.003) and Clinical Global Impression-Severity of Illness scale score (P = 0.01) but not Clinical Global Impression-Improvement scale score at study end point. Of the patients in the N-acetylcysteine group, 52.6% were full responders at the end of the study, which was significantly higher than 15% of the patients in the placebo group (P = 0.013).Conclusion: This trial suggests that N-acetylcysteine may be a safe and effective option to augment standard treatment in patients with refractory obsessive-compulsive disorder.