FLUOXETINE AFTER WEIGHT RESTORATION IN ANOREXIA NERVOSA

描述(摘自申请人摘要)：神经性厌食症(AN)是一种 严重的精神障碍，发病率很高，终生 可以说，死亡率与任何精神疾病的死亡率一样高。一个 本病预后不良的主要原因是 在成功的初步治疗后复发。患有常见病的患者 表现出其他精神障碍的症状，如严重的抑郁症和 强迫症，对以下治疗反应良好 药物治疗。因此，令人惊讶的是，对AN的药物治疗 一直都不成功。几乎所有的对照试验 在治疗的初始阶段进行了药物治疗，当 患者体重过轻。有可能药物是有限的。 在疾病阶段的效用，因为生理和 饥饿的神经化学效应。因此，探讨 在最初治疗后的AN患者中，药物的使用情况 扭转了饥饿的严重影响。 当前应用程序的目标是确定SSRI是否 与安慰剂相比，氟西汀可降低复发率并提高 在对AN进行初步治疗后，心理和行为得到恢复。在……里面 为了回答这个问题，一个两个站点(纽约和多伦多)，四年 提出了协作式R01研究。80名患有AN的患者 成功完成住院或重症监护患者的初步治疗 门诊计划将随机分配为接受氟西汀或安慰剂 在双盲条件下12个月，同时接受适当的 心理治疗。结果将在维护的基础上进行评估 体重和精神病理症状的减少是AN的特征。

DESCRIPTION (Adapted from the Applicant's Abstract): Anorexia nervosa (AN) is a serious psychiatric disorder with substantial morbidity and a lifetime mortality arguably as high as that associated with any psychiatric illness. A major contributor to the poor prognosis of this illness is the high rate of relapse that follows successful initial treatment. Patients with AN often exhibit symptoms of other psychiatric disorders, such as major depression and obsessive compulsive disorder, which respond favorably to treatment with medication. It is surprising therefore that medication treatment for AN has been consistently unsuccessful. Virtually all of the controlled trials of medication have been conducted during the initial phase of treatment, when patients are underweight. It is possible that medications are of limited utility during the phase of illness because of the physiological and neurochemical effects of starvation. Therefore, it may be useful to explore the utility of medication among patients with AN after initial treatment has reversed the acute effects of starvation. The goal of the current application is to determine whether the SSRI fluoxetine, compared to placebo, reduces the rate of relapse and enhances psychological and behavioral recovery following initial treatment for AN. In order to answer this question, a two-site (New York and Toronto), four year collaborative R01 study is proposed. Eighty patients with AN who have successfully completed initial treatment in an inpatient or intensive outpatient program will be randomly assigned to receive fluoxetine or placebo for 12 months under double-blind conditions while receiving appropriate psychological treatment. Outcome will be assessed on the basis of maintenance of weight and reduction in psychopathological symptoms characteristic of AN.