帕罗西汀与氯米帕明治疗强迫症的多中心、随机、双盲、平行对照研究

目的 比较帕罗西汀和氯米帕明治疗强迫症的疗效和安全性。方法 141例符合美国精神障碍诊断与统计手册第4版强迫症诊断标准的患者完成了研究，其中帕罗西汀治疗72例(帕罗西汀组)，氯米帕明治疗69例(氯米帕明组)，疗程均为10周。所有患者在入组前均服用安慰剂1周。帕罗西汀组第1周20mg／d；第2周30mg／d；第3周40mg／d；第4～10周低剂量组40mg／d，高剂量组50mg／d。氯米帕明组第1周50mg／d；第2周100mg／d；第3周150mg/d，第4～10周低剂量组150mg／d，高剂量组200mg／d。结果 帕罗西汀组痊愈率为21％，显效率为60％，总有效率为93％。氯米帕明组痊愈率为28％，显效率为57％，总有效率为90％。两组患者疗效的差异无显著性。帕罗西汀组不良反应发生率为18％，氯米帕明组不良反应发生率为43％，两组的差异有显著性(χ^2=10．54，P=0.00)。结论 帕罗西汀治疗强迫症的疗效与氯米帕明相当，但不良反应比帕罗西汀少而轻。

Comparison study of paroxetine and clomipramine in treatment of obsessive-compulsive disorder:a multicentre parallel randomized double-blind study

Objective To compare the efficacy and tolerability of paroxetine and clomipramine in treating patients with obsessive-compulsive disorder (OCD). Methods The study was a multicentre parallel randomized double-blind clinical trial. Three centers participated in this trial,with 73 patients receiving paroxetine and 73 receiving clomipramine treatment for 10 weeks. The diagnosis of OCD was made according to the 4 th edition of Diagnostic statistical Manual of Mental Disorder criteria. Results Five of the 146 cases dropped out,with 1 in paroxetine group,4 in clomipramine group. The patients in both groups showed significant improvement of obsessive-compulsive symptomatology according to the Yale-Brown Obsessive-Compulsive Scale score. The clinical recovery rates were 21% and 28% with total improved rates of 93% and 90%,respectively. Concerning tolerability,there were significantly higher adverse reactions in the clomipramine group,with adverse event incidence of 43% in comparison with 18% in paroxetine. Conclusions The results show that paroxetine and clomipramine have similar efficacy in treatment of patients with OCD,but paroxetine has better toleration.