阿立哌唑作为增效剂治疗强迫症的随机对照研究

目的探讨小剂量阿立哌唑作为增效剂治疗强迫症的疗效及安全性。方法 64例强迫症患者在帕罗西汀治疗的基础上,双盲、随机分为合用组帕罗西汀合并阿立哌唑,阿立哌唑平均剂量（标准差）为7.9（1.3）mg/d]及对照组（帕罗西汀合并维生素C）,治疗8周。于治疗前及治疗后分别采用Yale-Brow强迫量表、治疗时出现的症状量表（TESS）评定药物疗效及不良反应。结果治疗前合用组和对照组帕罗西汀的平均剂量（标准差）分别为30.2（5.1）mg/d、29.6（6.1）mg/d,差异无统计学意义（t=0.86,P=0.291）;合用组和对照组Y-BOCS评分的均分（标准差）分别为25.0（2.4）、25.1（2.6）,差异无统计学意义（t=0.89,P=0.379）,治疗后两组的评分分别为17.9（3.3）、23.0（2.5）,差异有统计学意义（t=15.89,P〈0.001）。治疗后两组TESS评分无统计学差异。结论小剂量阿立哌唑可作为增效剂治疗强迫症,8周治疗后未见严重不良反应。

Randomised double blind controlled trial of low-dose aripiprazole as an adjunctive treatment for obsessive compulsive disorder

Background：Many patients with obsessive compulsive disorder get limited benefit from standard treatment with SSRIs. Methods： 64 patients with obsessive compulsive disorder who had limited benefit after 8 weeks of treatment with paroxetine were continued on paroxetine and randomly assigned to a treatment group that received adjunctive treatment with aripiprazole titrated by clinical effect mean （sd） dose=7.9（1.3） mg/d] or a control group that received placebo （vitamin C）. The outcome was blindly assessed by administering the Yale-Brown Obsessive and Compulsive Symptoms scale （Y-BOCS） before and after 8 weeks of adjunctive treatment; adverse events were assessed using Treatment Emergent Symptoms Scale （TESS） during the course of the adjunctive treatment. Results： Prior to initiating the adjunctive treatment the mean （sd） daily dose of paroxetine in the treatment and control groups were 30.2 （5.1） and 29.6 （6.1） mg/d, respectively （t=0.86, P=0.291）; and the mean Y-BOCS scores were 25.0 （2.4） and 25.1 （2.6） respectively, （t=0.89, P= 0.379）. After 8 weeks of adjunctive treatment the mean Y-BOCS scores were 17.9 （3.3） and 23.0 （2.5）, respectively （t=15.89, P 0.001）. The mean TESS scores of the two groups at the end of the 8 weeks of adjunctive treatment were not significantly different. Conclusion： Low-dose aripiprazole is a useful adjunctive treatment for SSRIs in the management of obsessive compulsive disorder. No serious adverse effects are seen in 8 weeks of treatment with this combination of medications.