帕利哌酮缓释片联合选择性5-羟色胺再摄取抑制剂治疗难治性强迫障碍疗效观察

Efficacy observation of paliperidone extended-release tablets combined with SSRIs in the treatment of refractory obsessive-compulsive disorders

目的探讨帕利哌酮缓释片作为增效剂治疗难治性强迫障碍的疗效和耐受性。方法将59例难治性强迫症患者随机分为研究组和对照组。研究组29例,给予帕利哌酮缓释片（3~6 mg）联合选择性5-羟色胺再摄取抑制剂（SSRIs）;对照组30例,单用SSRIs。疗程为8周。在治疗前与治疗后4、8周末,采用耶鲁-布朗强迫量表（Y-BOCS）和副反应量表（TESS）评定疗效和不良反应。结果治疗第8周末,研究组和对照组的有效率分别为89.66%和46.67%,两组比较差异有统计学意义（P〈0.05）;研究组Y-BOCS评分为12.86±5.36,较治疗前（27.28±4.72）显著改善,且明显低于对照组（21.47±5.98）,差异均有统计学意义（P〈0.01）。两组不良反应程度均较轻微,TESS评分比较差异无统计学意义（P〉0.05）。结论小剂量帕利哌酮缓释片联合SSRIs治疗难治性强迫症较单用SSRIs有效,且安全性相当。

Objective To explore the efficacy and tolerability of paliperidone extended-release tablets （Pali- peridone ER） as a synergist in the treatment of refractory obsessive-compulsive disorders （OCD）. Methods Fifty- nine patients with refractory OCD were randomized into study group （ n = 29 ） and control group （ n = 30 ）. Patients in study group were given selective serotonin reuptake inhibitors （SSRIs） ＋ paliperidone ER 3 -6 mg, and patients in con- trol group only received SSRIs for 8 weeks. The efficacy and adverse reactions were evaluated by Yale-Brown Obsess- ive Compulsive Scale （Y-BOCS） and the treatment emergent symptom scale （TESS） at baseline and at the end of the 4 and 8 weeks. Results At the end of 8 weekes, the response rate in study group was significantly higher than that of control group （ 89. 66 % vs. 46. 67 %, P 〈 0. 05 ） ; the Y-BOCS score in study group decreased from 27.28 ± 4.72 before treatment to 12. 86± 5.36 after treatment （ P 〈 0. 01 ） , and there was significant difference between the two groups （ P 〈 0. 01 ）. No severe adverse effect was observed in either group, and no significant difference was found in TESS score between the two groups （ P 〉 0. 05 ）. Conclusion The small dose of paliperidone ER combined with SSRIs is more effective than single use of SSRIs in the treatment of refractory obsessive-compulsive disorders and the safety is similar.