Sertraline Combined With Fluvoxamine in the Treatment of Refractory Obsessive-compulsive Disorder

Study Overview
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Brief Summary
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To verify that sertraline combined with fluvoxamine is superior to sertraline combined with aripiprazole

Detailed Description
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To verify that sertraline combined with fluvoxamine is superior to sertraline combined with aripiprazole, and to observe the indicators of improving patients' cognitive function and adverse drug reactions, so as to provide evidence-based evidence for supplementing the treatment guidelines for obsessive-compulsive disorder

Official Title
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A Randomized Controlled Trial of Sertraline Combined With Fluvoxamine in the Treatment of Refractory Obsessive-compulsive Disorder

Conditions
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OCD

Intervention / Treatment
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* Drug: sertraline fluvoxamine
* Drug: sertraline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The Diagnostic criteria of OCD in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V), as well as the definition of refractory OCD, are as follows: failure to respond to oral treatment with at least two effective doses of antidepressants, including: Fluoxetine (≥20mg/ d), fluvoxamine (≥200mg/d), sertraline (≥150mg/d), and paroxetine (≥ 40mg/d) were all treated for at least 12 weeks. The Yale-Brown compulsive scale (Y-BOCS) score decreased by < 35%. The total score of Yale- Brown compulsion scale (Y-BOCS) ≥16 points. (3)age 12   45 years. Exclusion Criteria: Exclusion of severe organic brain disease; Severe physical illness; Other mental disorders such as tics, disruptive disorders, eating disorders and autism spectrum disorders; Pediatric streptococcal infection causedby autoimmune neuropsychiatric disease (PANDAS); Alcohol and drug dependence; Angle-closure glaucoma; Suicidal tendencies; Previous history of drug allergies related to research; Pregnant and lactating women.

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: sertraline combined with fluvoxamine<br>Sertraline combined with fluvoxamine treatment group: Gradually add the drug to the treatment dose, and monitor the symptom change, scale score, blood drug concentration and other indicators | Drug: sertraline fluvoxamine<br>* the initial dose of sertraline was given 50mg/d and the initial dose of fluvoxamine was 50mg/d, and the target dose of sertraline was gradually increased to 200mg/ d and the target dose of fluvoxamine was 200-300mg/d within 2 weeks, and the specific dose adjustment process was determined by the doctors on the basis of patients' conditions<br>* Other names: fluvoxamine;|
| Active Comparator: sertraline combined with aripiprazole<br>sertraline combined with aripiprazole treatment group:Gradually add the drug to the treatment dose, and monitor the symptom change, scale score, blood drug concentration and other indicators | Drug: sertraline<br>* The initial dose of sertraline was 50mg/d and the initial dose of aripiprazole was 5mg/d. The target dose of sertraline was 200mg/ d and the target dose of aripiprazole was 5-20mg/d within 2 weeks, and the specific dose adjustment process was determined by the doctors on the basis of patients' conditions<br>* Other names: aripiprazole;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Y-BOCS score | Treatment effectiveness was defined as a reduction of ≥35% in Y-BOCS score compared to baseline(12 weeks). Treatment recovery: Y-BOCS score below 8 (12 weeks) | 12 weeks | 
| Ratio of Y-BOCS score reduction from baseline | Treatment effectiveness was defined as a reduction of ≥35% in Y-BOCS score compared to baseline(12 weeks). | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sertraline, OCD, fluvoxamine