FLUOXETINE VS PLACEBO IN DEPERSONALIZATION DISORDER

人格解体障碍（DPD）是一种慢性的，潜在的致残性， 研究非常不足的精神疾病，通常认为是罕见的， 难治性 DPD患者患有持续性或 反复出现的不真实感和脱离各个方面的 自我，这导致极大的痛苦或干扰人际关系 或职业功能。 虽然有一个显着缺乏 系统研究流行病学，现象学和治疗 DPD，初步数据表明血清素再吸收抑制剂可能 具有显著的治疗效果。 然而，没有随机，对照， 已经进行了双盲药物治疗研究， 在DPD约会。 氟西汀是一种选择性5-羟色胺再摄取抑制剂， 初步研究中治疗DPD的疗效。 开放治疗 来自文献和我们自己的试点工作的数据表明， 回应率 我们对血清素的双盲试验性治疗数据 再摄取抑制剂氯丙咪嗪似乎同样有前途，50% 充分氯丙咪嗪试验的反应率，但也表明一个显着的 对三环类药物的副作用不耐受 系统评价氟西汀治疗精神分裂症的疗效， DPD，80名患者将进入门诊双盲 氟西汀与安慰剂治疗的随机12周平行研究。 治疗精神科医生每周对结果进行评估， 由一个不知道剂量和副作用的独立评估者进行。 应答者将继续进入双盲维持阶段， 另外6个月评估反应的持久性。 研究完成后，应提供系统的资料， 氟西汀治疗DPD急性期的疗效及持久性 的反应，并继续维持六个月， 精神残疾的成功治疗，以及 共病轴1和轴II诊断对治疗结果的影响。

Depersonalization disorder (DPD) is a chronic, potentially disabling and very understudied psychiatric disorder, generally believed to be rare and treatment-refractory. Patients with DPD suffer from a persistent or recurrent sense of unreality and detachment from various aspects of the self, which leads to great distress or interference with interpersonal or occupational functioning. Although there is a marked paucity of systematic research on the epidemiology, phenomenology and treatment of DPD, preliminary data suggest that serotonin reuptake inhibitors may be of significant therapeutic benefit. However, no randomized, controlled, double-blind pharmacological treatment studies have been conducted to date in DPD. Fluoxetine, a selective serotonin reuptake inhibitor, appears to have efficacy in the treatment of DPD in preliminary studies. Open treatment data from the literature and from our own pilot work suggest a 56% to 71% response rate. Our double-blind pilot treatment data with the serotonin reuptake inhibitor clomipramine appear similarly promising, with a 50% response rate for adequate clomipramine trials, but also suggest a marked intolerance for the side-effects of tricyclics. To systematically assess the efficacy of fluoxetine in the treatment of DPD, 80 patients will be entered into an outpatient double-blind randomized 12-week parallel fluoxetine versus placebo treatment study. Outcome will be rated weekly by the treating psychiatrist and every two weeks by an independent evaluator blind to dosage and side-effects. Responders will continue in a double-blind maintenance phase for an additional 6 months to assess durability of response. When completed, the study should provide systematic information on the efficacy of fluoxetine in the acute treatment of DPD, on the durability of response with six months of continued maintenance, on the change in psychiatric disability with successful treatment, and on the effect of comorbid Axis 1 and Axis Il diagnoses on treatment outcome.