TOPIRAMATE AUGMENTATION IN THE TREATMENT OF OCD

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。强迫症(OCD)通常被认为是一种慢性、终生疾病。在美国和国外进行的一些大规模流行病学研究的结果一直表明，强迫症是一种相对常见的精神疾病(Sachdev等人，1993)。虽然SRI在治疗强迫症方面是有效的，但它们也与几个重要的局限性有关，包括大多数强迫症患者的治疗效果延迟(治疗8-12周至基线)。大多数研究表明，25%-30%的强迫症患者不能耐受SRI治疗，甚至对SRI治疗有部分反应(氯丙咪嗪合作研究小组，1991)。最近以社区为基础的调查结果也提供了令人信服的支持，即强迫症通常与相当大的发病率有关。此外，据报道，强迫症患者具有更高的医疗使用率和显著的社会和性功能障碍(Steketee，1997)。虽然还没有对强迫症的治疗进行具体评估，但以前的报告表明托吡酯可能有益于各种精神疾病，包括情感障碍(Calabrese等人，2001年；McElroy等人，2000年)和创伤后应激障碍(Berlant等人，2002年)。此外，其中一些初步报告的结果表明，托吡酯在这些适应症中可能有快速起效，这些情况下的有效剂量可能低于通常被发现的癫痫治疗有效剂量。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Obsessive-Compulsive Disorder (OCD) is generally considered a chronic, life-long illness. The results from a number of large-scale epidemiological studies conducted in the U.S. and abroad have consistently demonstrated that OCD is a relatively common psychiatric illness (Sachdev et al., 1993). Although SRI's are effective in the treatment of OCD, they are also associated with several important limitations including a delayed onset of therapeutic efficacy (8-12 weeks of treatment to baseline) in most patients with OCD. Most studies suggest that 25-30% of patients with OCD will fail to tolerate or even partially respond to SRI therapy (The Clomipramine Collaborative Study Group, 1991). Results from recent community based investigations also provided compelling support that OCD is routinely associated with considerable morbidity. Additionally, patients with OCD are reported to have elevated rates of healthcare utilization and significant impairments in social and sexual functioning (Steketee, 1997). While not yet specifically evaluated in the treatment of OCD, previous reports suggest that topiramate may be beneficial in a variety of psychiatric illnesses including affective disorders (Calabrese et al., 2001; McElroy et al., 2000) and PTSD (Berlant et al., 2002). Moreover, results from some of these initial reports suggest that topiramate may have a rapid onset of action in these indications and that the effective dose for these conditions may be below that usually found to be effective for epilepsy treatment.