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首页> 外文期刊>Bulletin of Clinical Psychopharmacology >Clomipramine versus sertraline in the treatment of obsessive compulsive disorder
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Clomipramine versus sertraline in the treatment of obsessive compulsive disorder

机译：氯米帕明vs舍曲林治疗强迫症

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Objective: The aim of this study was to compare the efficacy, safety, and tolerability of sertraline and clomipramine in the treatment of obsessive-compulsive disorder (OCD). Method: Outpatients met the DSM-IV criteria for OCD for 1 year or longer and scores of . 20 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and . 4 on the Clinical Global Impression Severity Scale (CGI-S) were included in the study. Patients who had significant concomitant physical disease, suicidal tendency, a history of seizure or organic brain disorder, substance abuse within the previous sixth months, DSM-IV axis I diagnoses other than OCD and who had had medication for 1 month were not included in the study.Patients were randomized to receive 8-week of single-blind treatment with either fixed dose of sertraline (n=20) 50 mg/day or clomipramine (n=22) initially 50 mg?day and 150 mg/day after 1 week. No additional medication was given to patients. Clinical evaluations were conducted before the treatment and on two-week schedule throughout the 8-week trial using the Y-BOCS and theCGI-S. Results: Four of clomipramine (18.2%) and 2 of sertraline (10.0%) patients dropped out because of adverse events or lack of effectiveness. Thirty six patients completed the trial (sertraline n=18; clomipramine n=18). The mean baseline Y-BOCS and CGI-S scores were 24.95 and 4.75 respectively for sertraline and 23.54 and 4.85 for clomipramine (p>0.05). A significant reduction in OCD symptoms from baseline to the end of 8 th week of the trial was found in both sertraline and clomipramine treated groups (p0.05). The number of patients withdrawn because of adverse events was substantially greater for clomipramine (22.2%) than sertraline (11.1%). The incidence of side effects was significantly higher in clomipraminetreated patients versus sertraline-treated patients. The most frequent adverse events with sertraline were headache (38.8%), nausea (33.3%), irritability (11.1%) and tremor (11.1%), while clomipramine was most commonly associated with dry mouth (50%), weight gain (50%), constipation (27.7%), yawning (27.7%), sedation (22.2%) and dizziness (11.1%). Conclusions: At fixed doses, both clomipramine and sertraline showed a similar therapeutic efficacy in the treatment of OCD. Clomipramine produced more side effects and dropout rate. The results indicate that sertraline is as effective as clomipramine in the treatment of OCD and is better tolerated.
机译：目的：本研究的目的是比较舍曲林和氯米帕明治疗强迫症的疗效，安全性和耐受性。方法：门诊患者符合1年或更长时间的OCD的DSM-IV标准，得分为。在Yale-Brown强迫症量表（Y-BOCS）和20中排名第20。研究中包括了临床总体印象严重程度量表（CGI-S）中的4个。在前六个月内患有严重伴随身体疾病，自杀倾向，有癫痫发作或器质性脑病史，滥用药物，DSM-IV轴I诊断为OCD以外且已用药1个月的患者不包括在内。患者随机接受8周单盲治疗，固定剂量为舍曲林（n = 20）50 mg /天，或氯米帕明（n = 22）最初为50 mg？天，1周后为150 mg /天。没有给患者额外的药物。使用Y-BOCS和CGI-S在治疗前进行临床评估，并在整个8周的试验中按两周的时间表进行。结果：由于不良反应或缺乏疗效，氯米帕明4名（18.2％）和舍曲林2名（10.0％）退出研究。三十六名患者完成了该试验（舍曲林n = 18;氯米帕明n = 18）。舍曲林的平均基线Y-BOCS和CGI-S评分分别为24.95和4.75，氯米帕明的平均基线评分为23.54和4.85（p> 0.05）。舍曲林和氯米帕明治疗组从基线到试验的第8周末，强迫症症状均显着减轻（p0.05）。氯米帕明（22.2％）因不良事件而退出的患者人数明显多于舍曲林（11.1％）。氯米帕明治疗的患者的副作用发生率明显高于舍曲林治疗的患者。舍曲林最常见的不良事件是头痛（38.8％），恶心（33.3％），烦躁（11.1％）和震颤（11.1％），而氯米帕明最常与口干（50％），体重增加（50）相关％），便秘（27.7％），打哈欠（27.7％），镇静（22.2％）和头晕（11.1％）。结论：在固定剂量下，氯米帕明和舍曲林在强迫症的治疗中具有相似的疗效。氯米帕明产生更多的副作用和辍学率。结果表明，舍曲林在治疗强迫症方面与氯米帕明一样有效，并且耐受性更好。

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