精神医学63巻6号

2021年06月発行

特集 強迫についてあらためて考える

強迫症の薬物療法

著者： 住谷さつき¹

所属機関： ¹徳島大学キャンパスライフ健康支援センター

ページ範囲：P.923 - P.931

文献概要

抄録　強迫症(obsessive-compulsive disorder：OCD)の薬物治療の基本は選択的セロトニン再取り込み阻害薬(selective serotonin reuptake inhibitor：SSRI)を十分量，十分期間使用することであるが，SSRIで治療可能な症例は40〜60%とされている。はじめに使用したSSRIに効果が認められなかったり副作用で服用が難しかったりするときは他のSSRIに変更するか，非定型抗精神病薬の付加による増強療法を行うのが一般的である。抗精神病薬の付加に反応があるのは45〜70%とされているが，仮に半分の患者にSSRIが効果を示し残りの半分の半分が抗精神病薬の付加に反応しても，4分の1の患者は薬物治療抵抗性ということになる。近年，薬物治療抵抗性の患者に対しては別の機序の薬物による増強療法の効果も検証されており，特にグルタミン酸系の薬物に注目が集まっている。

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