Duloxetine augmentation in resistant obsessive compulsive disorder: Surveying a new medication for challenges in treatment of OCD

2017 ◽  
Vol 41 (S1) ◽  
pp. S415-S415
Author(s):  
A. Mowla
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Primary Outcome Measure ◽  
Controlled Clinical Trial ◽  
Double Blind Study ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Significant Difference ◽  
Competing Interest ◽  
To Receive

IntroductionUp to 50% of patients with OCD have failed to respond in SSRI trials, so looking for pharmacological alternatives in treatment of obsessive compulsive disorder (OCD) seems necessary.ObjectivesSurveying duloxetine augmentation in treatment of resistant OCD.AimsStudy the effects of serotonin-norepinephrine enhancers for treatment of OCD.MethodsThis augmentation trial was designed as an 8-week randomized controlled, double blind study. Forty-six patients suffering from OCD who had failed to respond to at least 12 weeks of treatment with a selective serotonin reuptake inhibitor (fluoxetine, citalopram or fluvoxamine) were randomly allocated to receive duloxetine or sertraline plus their current anti OCD treatment. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure.ResultsForty-six patients (24 of 30 in duloxetine group and 22 of 27 in sertraline group) completed the trial. Both groups showed improvement over the 8-week study period (mean Y-BOCS total score at week 8 as compared with baseline: P < 0.001 and P < 0.001) without significant difference (P = 0.861). Those receiving duloxetine plus their initial medications experienced a mean decrease of 33.0% in Y-BOCS score and the patients with sertraline added to their initial medication experienced a mean decrease of 34.5% in Y-BOCS.ConclusionsOur double blind controlled clinical trial showed duloxetine to be as effective as sertraline in reducing obsessive and compulsive symptoms in resistant OCD patients. However, it needs to be noted that our study is preliminary and larger double blind placebo controlled studies are necessary to confirm the results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Topiramate Augmentation in Resistant OCD: A Double-Blind Placebo-Controlled Clinical Trial

CNS Spectrums ◽  
2010 ◽  
Vol 15 (11) ◽  
pp. 613-617 ◽  
Author(s):  
Arash Mowla ◽  
Abdol Mohammad Khajeian ◽  
Ali Sahraian ◽  
Abdol Hamid Chohedri ◽  
Faramarz Kashkoli
Keyword(s):  
Placebo Group ◽  
Group Versus ◽  
Primary Outcome Measure ◽  
Controlled Clinical Trial ◽  
Double Blind Study ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Day Range

AbstractObjectivesGlutaminergic dysfunction has been shown to be related to the pathphysiology of obsessive-compulsive disorder (OCD). Topiramate is an antiepileptic that inhibits glutaminergic action. The aim of this study is to evaluate the efficacy of topiramate augmentation in patients with treatment resistant OCD.MethodsThis augmentation trial was designed as a 12-week randomized, placebocontrolled, double-blind study. Forty-nine patients suffering from OCD who had failed to respond to at least 12 weeks of treatment of an adequate and stable dose of a selective serotonin reuptake inhibitor (SSRI) were randomly allocated to receive topiramate or placebo plus their current anti OCD treatment. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Treatment response was defined as 25 % or more decrease in scores of Y-BOCS. The mean dosage of topiramate was 180.15 mg/day (range 100–200 mg/day).ResultsForty-one patients (20 of 24 in topiramate group; 21 of 25 in placebo group) completed the trial. The topiramate group showed significant improvement over the study period (mean Y-BOCS score at week 12 as compared with baseline: P=.000). Those receiving topiramate experienced a mean decrease of 32.0% in Y-BOCS score, compared with 2.4% decrease for those receiving placebo. Twelve patients in the topiramate group versus no patient in the placebo group were rated as responder.ConclusionThe results of our study demonstrated that topiramate may augment the therapeutic effect of SSRIs in treatment-resistant OCD patients. However, it should be noted that our study is preliminary and larger double-blind studies are needed to confirm these results.

Ondansetron Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder: A Randomized Placebo-Controlled Clinical Trial

2020 ◽  
Vol 22 (5) ◽  
Author(s):  
Zahra Sepehrmanesh ◽  
Mehdi Adel ◽  
Afshin Ahmadvand ◽  
Mojtaba Sehat
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Controlled Clinical Trial ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
First Line Therapy ◽  
Significant Difference

Background: Serotonin and dopamine are involved in the development of obsessive-compulsive disorder (OCD). Approximately 40% of OCD patients do not respond to the first-line therapy of treatment using selective serotonin reuptake inhibitors. Reportedly, the response to the treatment is increased by enhancing dopamine blockers. Objectives: The purpose of this study was to evaluate the efficacy and immunogenicity of ondansetron as a booster in the treatment of OCD patients. Methods: The present double-blind, randomized clinical trial (RCT) was conducted on 40 patients (16 males and 24 females) aged 18 to 60 years who met the DSM-V-TR-based OCD diagnostic criteria and had a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The patients were randomized to receive standard treatment and ondansetron (8 mg/day) or placebo for 12 weeks. They were examined using Y-BOCS and side-effect checklist at baseline, fourth, eighth, and twelfth weeks. Results: The patients in both groups were homogeneous and comparable in terms of age, marital sex status, type of obsession, anxiety, depression, age at the onset of disease, and the duration of disease. The Y-BOCS scores in the intervention and placebo groups were 27.15 ± 3.94 vs. 26.15 ± 4.94 at baseline, 25.40 ± 3.75 vs. 25.00 ± 4.79 in the fourth week, 20.85 ± 3.69 vs. 24.05 ± 4.97 (P = 0.026) in the eighth week, and 17.95 ± 3.43 vs. 21.65 ± 4.85 (P = 0.008) in the twelfth week, respectively. Significant changes occurred between the two groups at weeks 8 and 12; the difference between the two groups was significant (P = 0.015), whereas no significant difference was observed between the two groups before week 8. Conclusions: This 12-week, double-blind, and randomized clinical trial showed that ondansetron was a booster agent with a significant effect on patients with moderate to severe OCD. This study also showed that ondansetron is generally well tolerated by OCD patients. The response to the treatment also increased from the eighth week of treatment onwards. The severity of the disease was decreased at the end of the ondansetron intervention. The adjunct ondansetron treatment was recommended for OCD patients

A Double-Blind Study of Adjuvant Buspirone Hydrochloride in Clomipramine-Treated Patients with Obsessive-Compulsive Disorder

1992 ◽  
Vol 7 (1) ◽  
pp. 11-18
Author(s):  
TERESA A. PIGOTT ◽  
FRANCINE LʼHEUREUX ◽  
JAMES L. HILL ◽  
KATALIN BIHARI ◽  
SUZANNE E. BERNSTEIN ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Blind Study ◽  
Double Blind Study ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Buspirone Hydrochloride

Clomipramine versus Phenelzine in Obsessive–Compulsive Disorder

1992 ◽  
Vol 161 (5) ◽  
pp. 665-670 ◽  
Author(s):  
J. Vallejo ◽  
J. Olivares ◽  
T. Marcos ◽  
A. Bulbena ◽  
J. M. Menchón
Keyword(s):  
Clinical Trial ◽  
Depressive Symptoms ◽  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Double Blind Clinical Trial ◽  
Significant Difference

A double-blind clinical trial of clomipramine versus phenelzine was carried out on 30 patients suffering from DSM–III obsessive–compulsive disorder. The study period was 12 weeks, and the maximum doses used (from the fifth week on) were 225 mg/day for clomipramine (14 patients) and 75 mg/day for phenelzine (12 patients); four patients dropped out. Obsessive symptoms improved significantly in both drug groups, but there was no significant difference between groups. Depressive symptoms improved before obsessive ones.

St John??s wort versus placebo in obsessive???compulsive disorder: results from a double-blind study

2005 ◽  
Vol 20 (6) ◽  
pp. 299-304 ◽  
Author(s):  
Kenneth A. Kobak ◽  
Leslie V. H. Taylor ◽  
Alexander Bystritsky ◽  
Cary J. Kohlenberg ◽  
John H. Greist ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Blind Study ◽  
Double Blind Study ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder

scholarly journals Memantine Augmentation of Sertraline in Severity of Symptoms and Cognitive Function Among Patients with Obsessive-Compulsive Disorder: A Double-Blind Placebo-Controlled, Randomized Clinical Trial

2021 ◽  
Author(s):  
Sanaz Askari ◽  
Saba Mokhtari ◽  
Seyed Vahid Shariat ◽  
Behnam Shariati ◽  
Masoomeh Yarahmadi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cognitive Function ◽  
Obsessive Compulsive Disorder ◽  
Wisconsin Card Sorting Test ◽  
P Value ◽  
Card Sorting ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Significant Difference

Abstract Background: Medications currently recommended for the treatment of Obsessive-Compulsive Disorder (OCD) usually decrease the severity of the symptoms by 20–30%, and 40–60% of OCD patients do not achieve satisfactory treatment. In this study, the main objective was to investigate the effectiveness of memantine, which is a non-competitive N-Methyl-D-aspartate (NMDA) receptor antagonist, as an adjunct therapy to sertraline, a selective serotonin reuptake inhibitor (SSRI), to improve severity of symptoms and cognitive function among patients with obsessive-compulsive disorder. Methods: 70 patients who based on Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria were diagnosed with OCD, and had a Yale-Brown obsessive compulsive scale (Y-BOCS) score of more than 21, were recruited in a placebo controlled, double-blinded, parallel-group, clinical trial of 12 weeks to receive either memantine (10 mg twice daily) and sertraline (100 mg daily initially followed by 200 mg daily after week 4) or placebo and sertraline. The primary outcome was OCD symptoms measured by the Y-BOCS, moreover, the executive function and the cognition of participants was measured by the Wisconsin Card Sorting Test (WCST).Results: Y-BOCS score in total, obsession and compulsion subscales significantly dropped in both groups; however, there was not a significant difference between them. In comparison of cognition, memantine group showed a greater response in number of categories subscale in the WCST (p value<0.001). No major adverse effects were observed in any of the groups. Conclusion: Our findings suggest a probable effect of memantine as adjuvant therapy to sertraline on cognitive function of patients with OCD as well as its safety and tolerability in comparison with placebo. Nevertheless, the current results don`t support the efficacy of memantine as an adjunctive agent to sertraline for improving severity of symptoms among patients with OCD.Trial registration: The trial was registered at the Iranian Registry of Clinical Trials on 2019-10-04 (www.irct.ir; IRCT ID: IRCT20170123032145N4).

Paroxetine concentrations in obsessive-compulsive disorder: Support for a therapeutic interval

2017 ◽  
Vol 41 (S1) ◽  
pp. S322-S322
Author(s):  
M.B. Humble ◽  
M. Reis
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Clinical Symptoms ◽  
Global Evaluation ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Number Of Patients ◽  
The Mean ◽  
Competing Interest ◽  
L 13

IntroductionPrevious studies of concentrations of serotonin reuptake inhibitors (SRIs) versus therapeutic efficacy have yielded inconsistent results. Even if the relationships between the individual's serotonergic system and the clinical symptoms of obsessive-compulsive disorder (OCD) are poorly understood, the SRIs are consistently effective in OCD. However, studies on SRI concentrations in OCD treatment are rare.Objectives/aimsTo identify possible links between paroxetine concentrations and anti-obsessive response.MethodsIn a randomised, double-blind trial, comparing clomipramine, paroxetine and placebo in OCD treatment, serum paroxetine levels were measured after 1 week and after 4 weeks of treatment in 18 patients. Anti-obsessive response was assessed with Yale-Brown obsessive compulsive scale (Y-BOCS) and patients’ global evaluation (PGE), after 12 weeks of treatment.ResultsSerum paroxetine concentrations after 4 weeks suggested a therapeutic interval between 50 and 240 nmol/L (13–63 ng/mL). The mean Y-BOCS decrease was 54% inside versus 7% outside this interval (t = 3.96; P = 0.0011).ConclusionsParoxetine levels seemingly predicted clinical outcome. Studies with a greater number of patients are necessary in order to confirm this finding and to discern whether it is useful in clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Sign in / Sign up

Export Citation Format

Share Document