期刊
EUROPEAN NEUROPSYCHOPHARMACOLOGY
卷 29, 期 3, 页码 397-404出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.euroneuro.2018.12.010
关键词
Treatment-refractory obsessive-compulsive disorder; Methylphenidate (MPH) of extended-release formulations (MPH-ER); Augmentation
资金
- Medical Scientific Research Foundation of Guangdong Province [B2013006]
- Science and Technology Planning Project from Guangdong Province [2014A020212587]
- Science and Technology Special Foundation of Guangdong General Hospital
- Science and Technology Program of Guangzhou [201804010331]
- Natural Science Foundation of Guangdong Province [2018A030313989]
More effective, tolerable interventions for treatment-refractory obsessive-compulsive disorder (OCD) are needed. Preliminary findings encourage optimism that methylphenidate augmentation may be of benefit in the treatment of OCD. To test modulator methylphenidate (MPH) of extended-release formulations (MPH-ER) a safe and effective add-on therapy for refractory OCD, a pilot randomized, placebo-controlled, double-blind trial was conducted at an outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor (SRI) treatment-refractory OCD and receiving a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. Data were ana-lyzed in the intention-to-treat sample. All subjects were randomized into two parallel groups to receive fluvoxamine (250 mg daily) plus MPH-ER (36 mg daily) or fluvoxamine (250 mg daily) plus identical placebo tablets under double-blind conditions and followed for 8 weeks. Forty-four patients (29 [ 66%] men), with a mean (SD) age of 24.7 (6) years participated; with a mean (SD) duration of episode 5.7 (3) were randomized and forty-one finished the trial. In the intention-to-treat analysis, the improvement in the Y-BOCS total score and Y-BOCS obsession subscale score was more prominent in the fluvoxamine and MPH-ER group compared with those receiving placebo (P <.001). Additionally, cumulative response rates were higher in the MPH-ER vs placebo groups (59% vs 5%; P <.001). MPH-ER was well tolerated; No subjects dropped out due to side effects. In summary, combined treatment with MPH-ER demonstrated an enhanced clinical rate of response compared to placebo. Further trials should examine MPH-ER efficacy in a larger sample (c) 2018 Elsevier B.V. and ECNP. All rights reserved.
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