Glutamatergic Agents in the Treatment of Compulsivity and Impulsivity in Child and Adolescent Psychiatry: a Systematic Review of the Literature

Abstract. Objective: Research has implicated glutamatergic projections between the various frontal subregions in the pathogenesis of compulsivity and impulsivity. Reducing striatal glutamate release, or antagonising the action of glutamate at its receptors, may therefore represent viable treatment strategies. Several glutamatergic agents with regulatory approval for other indications are available and may be of potential benefit in the treatment of compulsivity/impulsivity in psychiatric disorders in paediatric patients. Method: This review was performed according to PRISMA guidelines and evaluates available scientific literature concerning the use of glutamatergic agents in these patients, in order to determine their reported effectiveness/efficacy and tolerability/safety. Results: Out of a total of 1,426 publications, 21 trials examining six glutamatergic substances in patients with obsessive-compulsive disorder, autism spectrum disorders, and attention deficit/hyperactivity disorder were included. Conclusions: Trial designs as well as results were heterogeneous and thus comparability was limited. Available data support the hypothesis that glutamatergic agents are of potential value in the treatment of compulsivity/impulsivity in children and adolescents. Based on the data reviewed, memantine and N-acetylcysteine suggest the best risk-benefit profile for future trials. Riluzole should primarily be further investigated in adults. Clinical research of this nature is a key element of the TACTICS Consortium project funded by the European Union (FP7).

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Olfactory Dysfunction in Neurodevelopmental Disorders: A Meta-analytic Review of Autism Spectrum Disorders, Attention Deficit/Hyperactivity Disorder and Obsessive–Compulsive Disorder

Journal of Autism and Developmental Disorders ◽

10.1007/s10803-020-04376-9 ◽

2020 ◽

Vol 50 (8) ◽

pp. 2685-2697 ◽

Cited By ~ 1

Author(s):

Andrew J. D. Crow ◽

Jennica M. Janssen ◽

Kayci L. Vickers ◽

Julia Parish-Morris ◽

Paul J. Moberg ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Autism Spectrum Disorders ◽

Neurodevelopmental Disorders ◽

Autism Spectrum ◽

Olfactory Dysfunction ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Hyperactivity Disorder ◽

Analytic Review ◽

Spectrum Disorders

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Outcomes of cognitive behaviour therapy for obsessive–compulsive disorder in young people with and without autism spectrum disorders: A case controlled study

Psychiatry Research ◽

10.1016/j.psychres.2015.03.012 ◽

2015 ◽

Vol 228 (1) ◽

pp. 8-13 ◽

Cited By ~ 39

Author(s):

Kim Murray ◽

Amita Jassi ◽

David Mataix-Cols ◽

Faye Barrow ◽

Georgina Krebs

Keyword(s):

Autism Spectrum Disorders ◽

Young People ◽

Cognitive Behaviour Therapy ◽

Autism Spectrum ◽

Controlled Study ◽

Behaviour Therapy ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Cognitive Behaviour ◽

Spectrum Disorders

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Obsessive-compulsive spectrum disorders

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2003.5.3/aallen ◽

2003 ◽

Vol 5 (3) ◽

pp. 259-271

Keyword(s):

Impulse Control ◽

Body Dysmorphic Disorder ◽

Patient Characteristics ◽

Autism Spectrum ◽

Sexual Compulsivity ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Diagnostic Categories ◽

Spectrum Disorders ◽

Fruitful Research

The obsessive-compulsive spectrum is an important concept referring to a number of disorders drawn from several diagnostic categories that share core obsessive-compulsive features. These disorders can be grouped by the focus of their symptoms: bodily preoccupation, impulse control, or neurological disorders. Although the disorders are clearly distinct from one another, they have intriguing similarities in phenomenology, etiology, pathophysiology, patient characteristics, and treatment response. In combination with the knowledge gained through many years of research on obsessive-compulsive disorder (OCD), the concept of a spectrum has generated much fruitful research on the spectrum disorders. It has become apparent that these disorders can also be viewed as being on a continuum of compulsivity to impulsivity, characterized by harm avoidance at the compulsive end and risk seeking at the impulsive end. The compulsive and impulsive disorders differ in systematic ways that are just beginning to be understood. Here, we review these concepts and several representative obsessive-compulsive spectrum disorders including both compulsive and impulsive disorders, as well as the three different symptom clusters: OCD, body dysmorphic disorder, pathological gambling, sexual compulsivity, and autism spectrum disorders.

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Repetitive thoughts and behaviors in Autism Spectrum Disorders and Obsessive Compulsive Disorder: From theory to practice

PsycEXTRA Dataset ◽

10.1037/e539192013-027 ◽

2006 ◽

Author(s):

Ioanna Tsiouri

Keyword(s):

Autism Spectrum Disorders ◽

Obsessive Compulsive Disorder ◽

Autism Spectrum ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Theory To Practice ◽

Spectrum Disorders ◽

And Behaviors

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Riluzole to Treat Child and Adolescent Obsessive-Compulsive Disorder With or Without Autism Spectrum Disorders

PsycEXTRA Dataset ◽

10.1037/e544312012-001 ◽

2012 ◽

Author(s):

Susan E Swedo

Keyword(s):

Autism Spectrum Disorders ◽

Obsessive Compulsive Disorder ◽

Child And Adolescent ◽

Autism Spectrum ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Spectrum Disorders

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Genetic influences on eight psychiatric disorders based on family data of 4 408 646 full and half-siblings, and genetic data of 333 748 cases and controls

Psychological Medicine ◽

10.1017/s0033291718002039 ◽

2018 ◽

Vol 49 (07) ◽

pp. 1166-1173 ◽

Cited By ~ 25

Author(s):

E. Pettersson ◽

P. Lichtenstein ◽

H. Larsson ◽

J. Song ◽

A. Agrawal ◽

...

Keyword(s):

Psychiatric Disorders ◽

Autism Spectrum ◽

Psychiatric Research ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Hyperactivity Disorder ◽

Unique Character ◽

Psychiatric Conditions ◽

Heritability Estimates ◽

Study Designs

AbstractBackgroundMost studies underline the contribution of heritable factors for psychiatric disorders. However, heritability estimates depend on the population under study, diagnostic instruments, and study designs that each has its inherent assumptions, strengths, and biases. We aim to test the homogeneity in heritability estimates between two powerful, and state of the art study designs for eight psychiatric disorders.MethodsWe assessed heritability based on data of Swedish siblings (N = 4 408 646 full and maternal half-siblings), and based on summary data of eight samples with measured genotypes (N = 125 533 cases and 208 215 controls). All data were based on standard diagnostic criteria. Eight psychiatric disorders were studied: (1) alcohol dependence (AD), (2) anorexia nervosa, (3) attention deficit/hyperactivity disorder (ADHD), (4) autism spectrum disorder, (5) bipolar disorder, (6) major depressive disorder, (7) obsessive-compulsive disorder (OCD), and (8) schizophrenia.ResultsHeritability estimates from sibling data varied from 0.30 for Major Depression to 0.80 for ADHD. The estimates based on the measured genotypes were lower, ranging from 0.10 for AD to 0.28 for OCD, but were significant, and correlated positively (0.19) with national sibling-based estimates. When removing OCD from the data the correlation increased to 0.50.ConclusionsGiven the unique character of each study design, the convergent findings for these eight psychiatric conditions suggest that heritability estimates are robust across different methods. The findings also highlight large differences in genetic and environmental influences between psychiatric disorders, providing future directions for etiological psychiatric research.

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