拉莫三嗪对SSRI类药物治疗阻抗的强迫症患者疗效观察

Clinical Observation on Lamotrigine Augmentation of SSRI in Treatment-Resistant Obsessive-Compulsive Disorder

目的:探讨拉莫三嗪对SSRI类药治疗阻抗的强迫症患者的疗效和临床安全性。方法:对60例SSRI类药治疗阻抗的强迫症患者,随机分为2组:实验组加用固定剂量拉莫三嗪(100mg/d);对照组只用安慰剂。分别于入组时、12周时进行Y-BOCS评定,比较2组减分情况。结果:入组时,2组患者Y-BOCS得分无差异(P> 0. 05)。第12周时,实验组在强迫思维、强迫行为和Y-BOCS总分的平均减分分别达到4. 06、3. 82和7. 88,对照组仅为2. 05、2. 18和4. 23,差异有统计学意义(P <0. 05)。实验组减分率为41. 36%,对照组为22. 78%。实验组副反应发生率33. 33%,对照组为23. 33%,但差异没有统计学意义(P> 0. 05),且2组均无明显严重或不可耐受的不良反应发生。结论:拉莫三嗪可有效改善对SSRI类药治疗阻抗的强迫症患者的强迫思维和强迫行为,且无明显增加不良反应。

[Objective]To explore the efficacy and clinical safety of lamotrigine in treatment-resistant obsessive-compulsive disorder(OCD)patients receiving selective serotonin reuptake inhibitors(SSRIs).[Method]60 patients with obsessive-compulsive disorder treated with SSRI drugs were randomly divided into 2 groups which received 100mg/d of lamotrigine(active group)or a placebo(control group).Y-BOCS score were collected at 0,12th week.[Result]There was no significant difference in Y-BOCS score between the two groups(P>0.05)at the beginning of this trail.At the 12th week,the average reduced score of obsessive thinking,compulsive behaviors and Y-BOCS score was 4.06,3.82,7.88,respectively,in active group and 2.05,2.18,4.23,respectively,in control group.The difference was marked significant as evidenced by changes on Y-BOCS(p=0.000;0.001;0.000).The score reduction rate were 41.36%of the active group and 22.78%in the control group.Incidence of adverse reactions was 33.33%in active group and 23.33%in control group.There was no significant difference in incidence of adverse reactions(P>0.05)between the two groups.The two groups expressed no obviously serious adverse reactions which can not be endured.[Conclusion]Lamotrigine can effectively improve the forced thinking and compulsive behavior of patients with obsessive-compulsive disorder treated with SSRI drugs,and does not significantly increase adverse reactions.