Quetiapine versus clomipramine in the augmentation of selective serotonin reuptake inhibitors for the treatment of obsessive-compulsive disorder: a randomized, open-label trial

被引:31
作者
Diniz, J. B. [1 ,2 ]
Shavitt, R. G. [2 ]
Pereira, C. A. B. [3 ]
Hounie, A. G. [2 ]
Pimentel, I. [2 ]
Koran, L. M. [4 ]
Dainesi, S. M. [5 ]
Miguel, E. C. [2 ]
机构
[1] Univ Sao Paulo, Sch Med, Dept Psychiat, Clin Hosp, Sao Paulo, Brazil
[2] Univ Sao Paulo, Sch Med, Inst Psychiat, Clin Hosp, Sao Paulo, Brazil
[3] Univ Sao Paulo, Math & Stat Inst, Sao Paulo, Brazil
[4] Stanford Univ, Med Ctr, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA
[5] Univ Sao Paulo, Sch Med, Clin Hosp, Clin Res Support Ctr, Sao Paulo, Brazil
基金
巴西圣保罗研究基金会;
关键词
clomipramine; obsessive compulsive disorder; psychiatry; quetiapine; serotonin reuptake inhibitors; DOUBLE-BLIND; ANTIPSYCHOTIC AUGMENTATION; TREATED PATIENTS; FLUOXETINE; ANTIDEPRESSANTS; PINDOLOL; DESIPRAMINE; COMBINATION; FLUVOXAMINE; CITALOPRAM;
D O I
10.1177/0269881108099423
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
After 12 weeks of selective serotonin reuptake inhibitor (SSRI) monotherapy with inadequate response, 10 patients received clomipramine and 11 received quetiapine as augmentation agents of the SSRI. The primary outcome measure was the difference between initial and final scores of the YaleBrown Obsessive-Compulsive Scale (Y-BOCS), rated in a blinded fashion, and the score of clinical global improvement (CGI-I). Statistical analyses were performed using nonparametric tests to evaluate treatment efficacy and the difference between treatment groups. Percentile plots were constructed with YBOCS scores from the clomipramine and quetiapine groups. Considering response a >= 35% reduction in the initial Y-BOCS score plus a rating of 'much improved' or 'very much improved' on CGI-I, four of eleven quetiapine patients and one out of ten clomipramine patients were classified as responders. The mean final Y-BOCS score was significantly lower than baseline in the quetiapine augmentation group (P = 0.023), but not in the clomipramine augmentation group (P = 0.503). The difference between groups showed a trend towards significance only at week 4, the mean Y-BOCS score being lower for those receiving quetiapine (P = 0.052). A difference between groups was also observed at week 4 according to percentile plots. These results corroborate previous findings of quetiapine augmentation efficacy in obsessive-compulsive disorder (OCD). Clomipramine augmentation did not produce a significant reduction in Y-BOCS scores. Higher target maximum dosages might have yielded different results.
引用
收藏
页码:297 / 307
页数:11
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