西酞普兰与氯米帕明治疗难治性强迫症的疗效和不良反应.docVIP

西酞普兰与氯米帕明治疗难治性强迫症的疗效和不良反应 【摘要】 目的：探讨西酞普兰与氯米帕明治疗难治性强迫症的疗效和不良反应。方法：对难治性强迫症64例，随机分为两组，分别用西酞普兰与氯米帕明治疗8周。采用强迫症量表 y-bocs 和副反应量表 tess 评价疗效及不良反应。结果：两组治疗后各周y-bocs评分均较治疗前下降 p 0.05 ；两药的总体疗效相仿。西酞普兰不良反应小。结论：西酞普兰治疗难治性强迫症郁疗效与氯米帕明相当，安全性高，不良反应轻微，依从性好。西酞普兰尤适用于难治性强迫症。 【关键词】 西酞普兰；氯米帕明；难治性强迫症 comparative study of citalopram and clomipramine in treatment of patients with refractory obsessive-compulsive disorder jiang chong-rong 【abstract】 objective: to compare the efficacy and side effects of citalopram and clomipramine in the treatment of patients with refractory obsessive-compulsive disorder ocd .method: sixty-four patients were randomly divided into two groups treated with citalopram and clomipramine respectively for 8 weeks. the efficacy and side effects were monitored with clinical evaluation, yale-brown obsessive compulsive scale y-bocs and treatment emergent symptoms scale tess .results:the scores of y-bocs decreased more markedly after the treatment than those before the treatment in two groups; there were no significant differences after the treatment in 4th, 6th, 8th weekend. citalopram and clomipramine were effective to refractory ocd, but citalopram had less side effects. conclusion: although citalopram has similar efficacy with clomipramine in the treatment of the patients with refractory obsessive-compulsive disorder ocd , but the former is safer with slighter side reaction and better compliance. citalopram is a more suitable drug for patients with refractory obsessive-compulsive disorder ocd . 【key words】 citalopram;clomipramine; refractory obsessive-compulsive disorder 难治性强迫症约占强迫症的20～30%,症状严重而迁延。我们进行了西酞普兰与氯米帕明治疗难治性强迫症的研究，现将结果报告如下。 1对象和方法 1.1对象 为2008年09月至2010年10月住我院精神科患者。符合中国精神障碍分类与诊断标准第3版强迫症诊断标准；曾经过≥2种ssri（或一种为氯米帕明）足量、足疗程（≥6周）治疗，强迫症状无明显好转；强迫症量表（y－bocs）≥16分，排除器质性疾病。共64例，随机分为两组。西酞普兰组32例，男13例，女19例；平均年龄 41.3±12.7 岁，平均病程 6.2士3.4 年。氯米帕明组32例，男17例，女15例；平均年龄 41.2±13.5 岁，平均病程 6.4±3.6 年。两组以上各项差异均无显著性 p均 0.05 。 1.2方法 停药清洗1周。西酞普兰剂量为50 ～150mg／d;氯米帕明剂量50～250 mg／d。失眠者给予阿普唑仑,均不合用其他抗