tailieunhanh - Báo cáo y học: "Switching from serotonin reuptake inhibitors to agomelatine in patients with refractory obsessive-compulsive disorder: a 3 month follow-up case series"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Switching from serotonin reuptake inhibitors to agomelatine in patients with refractory obsessive-compulsive disorder: a 3 month follow-up case series. | Fornaro Annals of General Psychiatry 2011 10 5 http content 10 1 5 ANNALS OF GENERAL PSYCHIATRY PRIMARY RESEARCH Open Access Switching from serotonin reuptake inhibitors to agomelatine in patients with refractory obsessive-compulsive disorder a 3 month follow-up case series Michele Fornaro Abstract Background Serotonin reuptake inhibitors SRIs currently represent the cornerstone of obsessive-compulsive disorder OCD pharmacotherapy. However OCD is characterized by high rates of partial and or absent response to standard recommended treatments often prompting pharmacological and non-pharmacological augmentation or switching of strategies. Agomelatine a novel melatonin agonist and selective serotonin antagonist MASSA antidepressant approved for major depressive disorder MDD has recently been additionally proposed as a treatment for anxiety disorders such as social anxiety disorder SAD and panic disorder PD but not yet OCD. Nonetheless agomelatine may have a role in the management of OCD essentially due to its anxiolytic 5-hydroxytryptamine HT 2C blockade action while melatonin MT 1 and MT2 modulation might contribute to circadian rhythm restoration if impaired. Methods This case series reports the outcome of six patients with or without comorbid mood and or other anxiety disorders who were treated with SRIs at adequate doses for at least 8 weeks showing partial or no response. Patients were then switched to agomelatine 50 mg day and followed up for 12 weeks. Results Three out of six patients in particular those with relevant circadian rhythm subjective impairment showed a Yale-Brown Obsessive Compulsive Scale Y-BOCS score reduction of 35 . No relevant side effects were observed but initial transient self-remitting dizziness in one patient and weight gain in another were seen. Conclusions Although clinical confounding factors subthreshold bipolarity and eventually the presence of impaired circadian rhythms and methodological boundaries

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