THE PHENOMENOLOGY AND TREATMENT OF OBESSIVE-COMPULSIVE DISORDER IN ADULTS

成人强迫症的现象和治疗

• 批准号: 3880832
• 负责人: D L MURPHY
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3880832
• 关键词: amitriptyline; antidepressants; clinical chemistry; computed axial tomography; electrophysiology; ergolines; human subject; human therapy evaluation; imipramine; interview; longitudinal human study; mental disorder chemotherapy; neuroendocrine system; neuropharmacology; neurotransmitter metabolism; obsessive compulsive disorder; placebos; psychobiology; serotonin

Our studies conducted in the last year on obsessive-compulsive disorder (OCD) have had a primary focus on investigations of the mechanisms which may mediate successful treatment of the disorder by serotonergic (5-HT) agents including clomipramine, fluoxetine, and buspirone. Investigations conducted here and elsewhere have conclusively shown that clomipramine is more effective than structurally similar tricyclics such as desipramine, imipramine, and amitriptyline, all of which our less selective for serotonin. However, in a controlled comparison to clomipramine conducted here, the serotonin agonist buspirone was found to have similar efficacy in the treatment of OCD. In addition, our group conducted the first double-blind comparison of clomipramine versus fluoxetine in the treatment of OCD and demonstrated similar efficacy in both a randomized and non-randomized cohort of patients. This apparent preferential response to 5-HT selective agents in OCD is in contrast to the treatment response demonstrated In other anxiety and depressive disorders which fail to show a preferential response to serotonin-selective agents and represents further evidence of the importance of serotonergic pathways in OCD. In preliminary studies further evaluating possible serotonergic contributions to therapeutic effects in OCD, brief coadministration of the serotonin agonist, m-chlorophenylpiperazine (M-CPP), during chronic clomipramine and fluoxetine treatment led to a relative attenuation of the behavioral responses elicited by m-CPP prior to medication treatment in a group of OCD patients.

我们的研究于去年进行了强迫症 （强迫症）主要关注研究机制的调查 可以通过血清素能（5-HT）介导该疾病的成功治疗 包括氯米帕明，氟西汀和丁螺酮在内的药物。调查 在这里和其他地方进行的，最终表明氯米帕明是 比结构上相似的三轮车（如去丙胺）更有效， 丙咪胺和阿米替林线，所有这些都不那么选择性 5-羟色胺。但是，在与氯米帕明进行的受控比较中 在这里，发现5-羟色胺激动剂丙酮在 强迫症的治疗。此外，我们的小组进行了第一个 氯米帕明与氟西汀的双盲比较 强迫症和在随机和 非随机患者队列。这种明显的优惠响应对 OCD中的5-HT选择性剂与治疗反应相反 在其他焦虑和抑郁症中表现出来的 对5-羟色胺选择剂的优先反应，并进一步代表 5-羟色胺能途径在强迫症中的重要性的证据。在初步 研究进一步评估了可能的血清素能贡献 OCD的治疗作用，羟色胺的简短共同给药 慢性氯米帕明和 氟西汀治疗导致行为相对衰减 在一组强迫症中，M-CPP在药物治疗之前引起的反应 患者。