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71.
目的:比较氟伏沙明合并丁螺环酮与氟伏沙明治疗难治性强迫症的疗效。方法:将符合条件的60例难治性强迫症患者随机分成两组,分别给与氟伏沙明合并丁螺环酮(合用组)和氟伏沙明(对照组),进行12周的系统治疗,使用Yale—Brown强迫量表(Y—BOCS),汉密尔顿焦虑量表(HAMA)评估其疗效;以治疗中出现的症状量表(TESS)和有关的实验室检查评定不良反应。结果:治疗以后丽组患者的Y-BOCS评分均明显下降,合用组的治疗效果较好,两组之间差异存在显著性(P〈0.01),并且合用组起效快;而两组HAMA量表的评分明显下降,合用组的治疗效果较好,两组之间差异存在显著性(P〈0.01),合用组起效快;合用组的不良反应发生率高于对照组,但差异无显著性;两组药物引起的不良反应均为轻度或中度,表现有所不同,患者耐受性好。结论:氟伏沙明合并丁螺环酮治疗难治性强迫症的疗效优于单独使用氟伏沙明组,且合用组起效较快,不良反应较轻。 相似文献
72.
Meredith A Fox Alison R Stein Helen T French Dennis L Murphy 《British journal of pharmacology》2010,159(4):879-887
Background and purpose:
Despite decreased presynaptic 5-HT1A and altered 5-HT2A receptor function in genetically-deficient serotonin (5-HT) transporter (SERT) mice, the 5-HT1A receptor antagonist N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinylcyclohexanecarboxamide maleate salt (WAY 100635) still induced head twitches in these mice, a well-established 5-HT2A receptor-mediated response.Experimental approach:
Interactions between 5-HT1A and 5-HT2A receptors were assessed using the head-twitch response following 5-HT1A and 5-HT2A receptor agonists and antagonists in SERT wild-type (+/+), heterozygous (+/−), and knockout (−/−) mice. The role of brain 5-HT availability in WAY 100635 induced head twitches was also examined.Key results:
WAY 100635 induced head twitches in a SERT gene-dose dependent manner, inducing 5-fold more head twitches in SERT −/− versus SERT +/+ mice. In SERT −/− mice, inhibition of 5-HT synthesis with p-chlorophenylalanine (PCPA) markedly depleted tissue 5-HT in all five brain areas examined and abolished WAY 100635 induced head twitches. Further, the selective 5-HT reuptake inhibitor fluvoxamine increased WAY 100635 induced head twitches in SERT +/+ and +/− mice. Head twitches following the 5-HT2A receptor agonist (+/−)-2,5-dimethoxy-4-iodophenyl-2-aminopropane (DOI) were robust in SERT +/+ and +/− mice but much reduced in SERT −/− mice. DOI-induced head twitches were decreased by the 5-HT1A agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) in SERT +/+ and +/− mice. All drug-induced head twitches were blocked by the 5-HT2A receptor antagonist a-Phenyl-1-(2-phenylethyl)-4-piperidinemethanol (MDL 11,939).Conclusions and implications:
These data show that indirect activation of 5-HT2A receptors via blockade of presynaptic 5-HT1A receptors potentiated head-twitch responses, suggesting functional interactions between these receptors, interactions affected by altered 5-HT availability. Our findings strongly support the correlation of WAY 100635 induced head twitches with increased 5-HT availability, induced genetically or pharmacologically. 相似文献73.
Mark Zetin 《Stress and health》1990,6(4):311-321
Obsessive–compulsive disorder is a well-defined clinical syndrome which has been very difficult to treat with standard psychotherapies and medications. There is a ‘hidden epidemic’ of silent sufferers who will begin seeking treatment as general knowledge of the efficacy of serotinin reuptake inhibitor antidepressants and behavioral therapy becomes widespread. The serotonin model requires us to reconceptualize the monoamine reuptake inhibitors as more than antidepressants and raises the issue of whether there is a commonality in the biology of compulsions, impulsivity, bulimia, and suicide. 相似文献
74.
Different inhibitory effect of fluvoxamine on omeprazole metabolism between CYP2C19 genotypes 总被引:4,自引:0,他引:4
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Yasui-Furukori N Takahata T Nakagami T Yoshiya G Inoue Y Kaneko S Tateishi T 《British journal of clinical pharmacology》2004,57(4):487-494
AIMS: Omeprazole is mainly metabolized by the polymorphic cytochrome P450 (CYP) 2C19. The inhibitory effect of fluvoxamine, an inhibitor of CYP2C19 as well as CYP1A2, on the metabolism of omeprazole was compared between different genotypes for CYP2C19. METHODS: Eighteen volunteers, of whom six were homozygous extensive metabolizers (EMs), six were heterozygous EMs and six were poor metabolizers (PMs) for CYP2C19, participated in the study. A randomized double-blind, placebo-controlled crossover study was performed. All subjects received two six-day courses of either daily 50 mg fluvoxamine or placebo in a randomized fashion with a single oral 40 mg dose of omeprazole on day six in both cases. Plasma concentrations of omeprazole and its metabolites, 5-hydroxyomeprazole, omeprazole sulphone, and fluvoxamine were monitored up to 8 h after the dosing. RESULTS: During placebo administration, geometric means of peak concentration (C(max)), under the plasma concentration-time curve from 0 to 8 h (AUC(0,8 h)) and elimination half-life (t(1/2)) of omeprazole were 900 ng ml(-1), 1481 ng ml(-1) h, and 0.6 h in homozygous EMs, 1648 ng ml(-1), 4225 ng ml(-1) h, and 1.1 h in heterozygous EMs, and 2991 ng ml(-1), 11537 ng ml(-1) h, and 2.8 h in PMs, respectively. Fluvoxamine treatment increased C(max) of omeprazole by 3.7-fold (95%CI, 2.4, 5.0-fold, P < 0.01) and 2.0-fold (1.4, 2.6-fold, P < 0.01), AUC(0,8 h) by 6.0-fold (3.3, 8.7-fold, P < 0.001) and 2.4-fold (1.7, 3.2-fold, P < 0.01), AUC(0, infinity ) by 6.2-fold (3.0, 9.3-fold, P < 0.01) and 2.5-fold (1.6, 3.4-fold, P < 0.001) and prolonged t((1/2)) by 2.6-fold (1.9, 3.4-fold, P < 0.001) and 1.4-fold (1.02, 1.7-fold, P < 0.05), respectively. However, no pharmacokinetic parameters were changed in PMs. The AUC(0,8 h) ratios of 5-hydroxyomeprazole to omeprazole were decreased with fluvoxamine in homozygous EMs (P < 0.05) and heterozygous EMs (P < 0.01). CONCLUSIONS: Even a low dose of fluvoxamine increased omeprazole exposure in EMs, but did not increase omeprazole exposure in PMs after a single oral dose of omeprazole. These findings confirm a potent inhibitory effect of fluvoxamine on CYP2C19 activity. The bioavailability of omeprazole might, to some extent, be increased through inhibition of P-glycoprotein during fluvoxamine treatment. 相似文献
75.
Neylan TC Metzler TJ Schoenfeld FB Weiss DS Lenoci M Best SR Lipsey TL Marmar CR 《Journal of traumatic stress》2001,14(3):461-467
This study assesses the efficacy of fluvoxamine treatment on different domains of subjective sleep quality in Vietnam combat veterans with chronic posttraumatic stress disorder (PTSD). Medically healthy male Vietnam theater combat veterans (N = 21) completed a 10-week open label trial. Fluvoxamine treatment led to improvements in PTSD symptoms and all domains of subjective sleep quality. The largest effect was for dreams linked to the traumatic experience in combat. In contrast, generic unpleasant dreams showed only a modest response to treatment. Sleep maintenance insomnia and the item troubled sleep showed a large treatment response, whereas sleep onset insomnia improved less substantially. These therapeutic benefits contrast with published reports that have found activating effects of Selective Serotonin Reuptake Inhibitors on the sleep electroencephalogram. 相似文献
76.
A double-blind, multinational study was conducted to compare the efficacy and safety of fluvoxamine and fluoxetine in outpatients with major depressive episode; 184 patients were randomised to fluvoxamine (100 mg/day) or fluoxetine (20 mg/day) for 6 weeks. Both drugs were effective and there were no statistically significant differences between them in the area under the curve of change from baseline in the Hamilton depression rating scale (HAMD) total score. However, the percentage of HAMD responders (>or= 50% decrease in HAMD total score) at week 2, the clinical global improvement severity of illness score at week 2 and the depression subscale of the irritability, depression and anxiety scale at weeks 1, 2 and 4, all showed significant advantages for fluvoxamine. During the last 2 weeks, fluvoxamine was significantly more effective in improving the HAMD sleep disturbance scale. Both drugs were well tolerated and there were no marked differences in their side effect profiles which were typical of SSRIs. Fluvoxamine and fluoxetine have similar efficacy and safety profiles in the treatment of major depressive episode; the findings of this study indicate that fluvoxamine may have a faster onset of action with respect to resolution of depressive symptoms and result in a better improvement in sleep quality. 相似文献
77.
Donald W. Black Janelle Gabel Jeffrey Hansen Steven Schlosser 《Annals of clinical psychiatry》2000,12(4):205-211
Nondepressed outpatients with a compulsive buying disorder were recruited by advertisement and word of mouth for inclusion in a controlled treatment trial. Following a 1-week single-blind placebo washout, subjects were randomly assigned to fluvoxamine (n = 12) or placebo (n = 11). Subjects received fluvoxamine (up to 300 mg daily) or placebo for 9 weeks. There were few dropouts. Outcome measures included the Yale–Brown Obsessive-Compulsive Scale—Shopping Version (YBOCS-SV), three Clinical Global Impressions (CGI) ratings, the Hamilton Rating Scale for Depression (HRSD), and the Maudsley Obsessive-compulsive Inventory (MOI). At the conclusion of the trial, 50% of fluvoxamine recipients and 63.6% of placebo recipients achieved CGI ratings of much or very much improvement, while 33% of fluvoxamine recipients were very much improved compared with 18% of placebo recipients (by endpoint analysis). Subjects in both treatment cells showed improvement as early as the second week of the trial, and for most, improvement continued during the 9-week study. There were no significant differences between fluvoxamine- and placebo-treated subjects on any of the outcome measures, with the exception that fluvoxamine recipients achieved greater improvement than placebo recipients on the MOI (p = .02). Adverse experiences were more frequent in the group receiving fluvoxamine, particularly nausea, insomnia, decreased motivation, and sedation. We conclude that in a short-term treatment trial of compulsive buying, subjects receiving fluvoxamine or placebo respond similarly. 相似文献
78.
Actigraphy is the continuous measurement of the motor component of behaviour. A change in behaviour will result in a change in activity. Drugs that are behaviourally toxic will cause changes in activity which can be measured using an actigraph. It is hypothesized that a reduction in daytime activity is a measure of sedation. A study was conducted comparing actigraphy with valid, reliable psychometric tests which are sensitive to the behaviourally toxic effects of psychoactive drugs. The study was designed to investigate whether actigraphy could accurately measure the daytime sedation associated with tricyclic antidepressants. The effects of fluvoxamine and dothiepin on behavioural activity and psychomotor abilities, in 12 healthy male volunteers, was investigated in a placebo-controlled, double-blind, crossover study. Subjects completed a battery of psychometric tests prior to dosing then at 1, 2, 3, 4 and 6 h post dose. Actigraphy showed that dothiepin caused daytime sedation, defined as a reduction in activity and this result was confirmed by the results from the psychometrics which showed that dothiepin impaired cognitive and psychomotor performance in the majority of the tests. These results show that actigraphy is capable of accurately measuring daytime sedation. © 1997 John Wiley & Sons, Ltd. 相似文献
79.
氟伏沙明治疗少年儿童强迫症临床观察 总被引:7,自引:1,他引:6
目的:探讨氟伏沙明治疗少年儿童强迫症的疗效和安全性。方法:以氟伏沙明治疗少年儿童强迫症34例。疗程10周。根据临床症状改善和社会功能恢复程度,不良反应及实验室检查评定疗效与安全性。结果:氟伏沙明平均治疗剂量(108±20)mg/d,显效率61.8%,有效率94.1%。不良反应有口干,轻度兴奋。结论:氟伏沙明治疗少年儿童强迫症安全有效,不良反应少。 相似文献
80.
目的探讨利培酮联合氟伏沙明治疗抽动障碍的疗效及安全性。方法将29例抽动障碍患儿随机分为利培酮联合氟伏沙明治疗组15例及利培酮治疗组14例,观察治疗8w,采用耶鲁抽动症严重程度量表及副反应量表评定临床疗效和不良反应。结果耶鲁抽动症严重程度量表评定,治疗4、8w末两组运动抽动和发声抽动的五个要素评分均较治疗前有显著或极显著性下降(P〈0.05或0.01);治疗4w末研究组损伤因子、总分均较对照组下降显著(P〈0.01);治疗8w末频率、干扰度要素及运动、发声、损伤因子和总分评分均显著低于照组(P〈0.01),两组不良反应发生率均较低,且程度较轻。结论利培酮联合氟伏沙明治疗抽动障碍起效快,疗效增加,安全性高,依从性好。 相似文献