IS THE EFFICACY OF TOPICAL CORTICOSTEROID-THERAPY FOR PSORIASIS-VULGARIS ENHANCED BY CONCURRENT MOCLOBEMIDE THERAPY - A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

Background: Psychosocial factors have been implicated in the onset and exacerbation of psoriasis. Objective: We conducted a randomized, plac ebo-controlled, double-blind study to investigate the effect of an ant idepressant agent, moclobemide, on the course of psoriasis vulgaris. M ethods: Sixty subjects were enrolled in the study. Patients were rando mly assigned to treatment groups. Patients received moclobemide 450 mg /day or placebo and a topical corticosteroid ointment (diflucortolone valerate) for 6 weeks. Patients were examined at the beginning of the study and at 2-week intervals. At each visit, the severity of psoriasi s and psychologic status were evaluated with the Psoriasis Area Severi ty Index (PASI), Beck Depression Inventory (BDI), Hamilton Rating Scal e for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HRS-D-17) and State-Trait Anxiety Inventory including state (STAI-1) and trait anxiety (STAI-2). Results: Treatment efficacy was able to be evaluated in 22 patients in the moclobemide-treated group and in 20 in the plac ebo-treated group. The improvement rates in PASI, BDI, STAI-1, and HAM -A scores were significantly higher in the moclobemide treatment group . The level of state anxiety was diminished in the moclobemide group. Correlation was positive between improvement rates of the psoriatic le sions and state anxiety in all patients. Conclusion: Our results sugge st that an antidepressant drug is useful in the treatment of psoriasis .