难治性强迫症的治疗进展

Developments in the treatment of refractory obsessive-compulsive disorder

强迫症是一种慢性易致残性疾病,有些患者经药物治疗无效。难治性强迫症(ROCD)的药物治疗策略包括:抗精神病药物与5-羟色胺再摄取抑制剂(SRI)联用,换用不同作用机制的抗抑郁药(如氯米帕明、文拉法辛)以及采用静脉注射途径给药的治疗方案等。同时,神经外科手术也是ROCD的主要治疗手段。深部脑刺激(DBS)作为一种新型功能性神经外科手术方式,与其他损伤性手术相比,优势明显。

Obsessive-compulsive disorder is a chronic and disabling disease. Some patients are refractory to medication. The therapeutic strategies against refractory obsessive-compulsive disorder （ROCD） include combining antipsychotics with serotonin reuptake inhibitors （SRIs） and switching to other antidepressants with different mode of action, such as clomipramine and venlafaxine. Neurosurgery is used as a therapeutic tool in ROCD as well, As a new approach of functional neurosurgery the deep brain stimulation （DBS） is of better advantages than other lesioning procedures.