High-dose escitalopram for the treatment of obsessive–compulsive disorder
High-dose escitalopram for the treatment of obsessive–compulsive disorder
复制标题
大剂量艾司西酞普兰治疗强迫症
DOI：
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发表时间：
2008
影响因子：
2.6
通讯作者：
Y. Barak
中科院分区：
文献类型：
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作者：
Ilan Rabinowitz;Y. Baruch;Y. Barak
本研究的目的是评估大剂量艾司西酞普兰治疗强迫症（OCD）患者的疗效和耐受性。在一项开放标签、16周前瞻性研究中，强迫症患者在以10 mg/天剂量滴定1周后，以20 mg/天剂量接受艾司西酞普兰治疗3周。在这4周内，Yale-Brown强迫量表（Y-BOCS）评分较基线降低≥25%的患者继续接受更高剂量的艾司西酞普兰（最大50 mg/天）治疗12周。强迫症症状的主要疗效指标是Y-BOCS评分较基线的变化。总体而言，67名患者（33名女性，34名男性）进入研究，平均Y-BOCS评分为29.6。标准剂量艾司西酞普兰治疗4周后，1例患者因妊娠而停药，2例患者Y-BOCS降低≥ 25%。因此，64例患者有资格接受高剂量艾司西酞普兰（终点时平均剂量为33.8 mg/天）。在终点，与基线相比，高剂量艾司西酞普兰显著改善了强迫症症状（Y-BOCS评分）和所有其他疗效指标（P<0.001）。艾司西酞普兰的耐受性也很好，在12周的高剂量阶段没有停药。唯一报告的药物不良反应是口干（n=8，12.1%）和性欲下降（n=21，31.8%）。初步研究表明，大剂量艾司西酞普兰对重度强迫症患者是一种有效且耐受性良好的治疗方法。需要进行随机、盲法研究来加强这些发现。
The aim of this study was to evaluate the efficacy and tolerability of high-dose escitalopram in patients suffering from obsessive–compulsive disorder (OCD). In an open-label, 16-week prospective study, patients with OCD received escitalopram at a dose of 20 mg/day for 3 weeks, after a 1-week titration at 10 mg/day. Patients who did not achieve a ≥25% reduction from baseline in the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) score during these 4 weeks were continued on higher doses of escitalopram (maximum 50 mg/day) for 12 weeks. The primary efficacy measure of OCD symptoms was change from baseline in the Y-BOCS score. Overall, 67 patients (33 women, 34 men) with a mean Y-BOCS score of 29.6 entered the study. After 4 weeks of standard-dose escitalopram treatment, one patient discontinued owing to pregnancy, and two patients achieved a reduction in Y-BOCS ≥25%. Consequently, 64 patients were eligible to receive high-dose escitalopram (mean dose, 33.8 mg/day at endpoint). At endpoint, high-dose escitalopram had significantly improved the OCD symptoms (Y-BOCS score) and all the other efficacy measures (P<0.001), compared with baseline. Escitalopram was also well tolerated, with no discontinuations during the 12-week high-dose phase. The only reported adverse drug reactions were dry mouth (n=8, 12.1%) and decreased sexual desire (n=21, 31.8%). Preliminary investigation shows that high-dose escitalopram is an efficacious and well tolerated treatment for patients suffering from severe OCD. Randomized, blinded studies are needed to reinforce these findings.
影响因子：
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作者：
W. Goodman;L. Price;S. Rasmussen;C. Mazure;Roberta L. Fleischmann;Candy L. Hill;G. Heninger;D. Charne
通讯作者：
W. Goodman;L. Price;S. Rasmussen;C. Mazure;Roberta L. Fleischmann;Candy L. Hill;G. Heninger;D. Charne