Aims More than one-half of betel-quid (BQ) chewers have betel-quid use disorder (BUD). However, no medication has been approved. We performed a randomised clinical trial to test the efficacy of taking escitalopram and moclobemide antidepressants on betel-quid chewing cessation (BQ-CC) treatment. Methods We enrolled 111 eligible male BUD patients. They were double-blinded, placebo-controlled and randomised into three treatment groups: escitalopram 10 mg/tab daily, moclobemide 150 mg/tab daily and placebo. Patients were followed-up every 2 weeks and the length of the trial was 8 weeks. The primary outcome was BQ-CC, defined as BUD patients who continuously stopped BQ use for ⩾6 weeks. The secondary outcomes were the frequency and amount of BQ intake, and two psychological rating scales. Several clinical adverse effects were measured during the 8-week treatment. Results Intention-to-treat analysis shows that after 8 weeks, two (5.4%), 13 (34.2%) and 12 (33.3%) of BUD patients continuously quit BQ chewing for ⩾6 weeks among placebo, escitalopram, moclobemide groups, respectively. The adjusted proportion ratio of BQ-CC was 6.3 (95% CI 1.5–26.1) and 6.8 (95% CI 1.6–28.0) for BUD patients who used escitalopram and moclobemide, respectively, as compared with those who used placebo. BUD patients with escitalopram and moclobemide treatments both exhibited a significantly lower frequency and amount of BQ intake at the 8th week than those with placebo. Conclusions Prescribing a fixed dose of moclobemide and escitalopram to BUD patients over 8 weeks demonstrated treatment benefits to BQ-CC. Given a relatively small sample, this study provides preliminary evidence and requires replication in larger trials.

中文翻译：

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抗抑郁药对槟榔使用障碍停止治疗的影响：一项随机、双盲、安慰剂对照试验

目标 超过一半的槟榔 (BQ) 咀嚼者患有槟榔使用障碍 (BUD)。但是，尚未批准任何药物。我们进行了一项随机临床试验，以测试服用依他普仑和吗氯贝胺抗抑郁药对槟榔咀嚼停止 (BQ-CC) 治疗的疗效。方法 我们招募了 111 名符合条件的男性 BUD 患者。他们是双盲、安慰剂对照并随机分为三个治疗组：依他普仑每天 10 毫克/标签，吗氯贝胺每天 150 毫克/标签和安慰剂。每2周对患者进行一次随访，试验时间为8周。主要结果是 BQ-CC，定义为 BUD 患者连续停止使用 BQ ⩾ 6 周。次要结果是 BQ 摄入的频率和数量，以及两个心理评定量表。在 8 周的治疗期间测量了几种临床不良反应。结果意向治疗分析显示，8周后，安慰剂组、依他普仑组、吗氯贝胺组分别有2名（5.4%）、13名（34.2%）和12名（33.3%）的BUD患者连续戒断BQ咀嚼⩾6周. 与使用安慰剂的患者相比，使用依他普仑和吗氯贝胺的 BUD 患者的 BQ-CC 调整比例分别为 6.3（95% CI 1.5-26.1）和 6.8（95% CI 1.6-28.0）。接受依他普仑和吗氯贝胺治疗的 BUD 患者在第 8 周的 BQ 摄入频率和摄入量均显着低于接受安慰剂的患者。结论 给 BUD 患者开出固定剂量的吗氯贝胺和依他普仑 8 周以上对 BQ-CC 有治疗益处。给定一个相对较小的样本，