scholarly journals Evaluation of Clonidine Augmentation Therapy for Obsessive-Compulsive Disorder Treatment; a Randomized Clinical Trial

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Shahla Akouchakian ◽  
Mohammad Javad Tarrahi ◽  
Elham Mohebati
Keyword(s):  
Clinical Trial ◽  
Adverse Effects ◽  
Randomized Clinical Trial ◽  
Obsessive Compulsive Disorder ◽  
P Value ◽  
Augmentation Therapy ◽  
Obsessive Compulsive ◽  
Global Improvement ◽  
Compulsive Disorder ◽  
Significant Difference

Background: Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder worldwide. Inadequate response of OCD patients to a usual agent makes this disorder a great challenge, and recent studies have recommended augmentation therapy as a new choice. Objectives: As traces of noradrenergic dysfunction have been noted in OCD pathophysiology, the current study aimed to assess the efficacy of clonidine augmentation therapy for treating OCD. Methods: This was a randomized clinical trial conducted on 57 OCD patients divided into the two groups of 1-mg clonidine augmentation therapy (n = 28) and placebo group (n = 29). The medication was administered for 12 weeks. Patients’ primary treatment, including SSRIs or clomipramine, continued by receiving the same dose used before participation in this study. The Yale-Brown Obsessive-Compulsive scale (Y-BOCS) and Clinical Global Impression-Severity scale (CGI-S) were used to assess the patients at the start of the study and then at four-week intervals. Drug-related adverse effects and global improvement were assessed and compared between the two groups. Results: The initial CGI scores were 3.89 ± 1.57 and 4.10 ± 1.61 at the baseline and 2.29 ± 1.18 and 3.07 ± 1.51 at the end of the study in the intervention and control groups, respectively. Both groups revealed a significant improvement (P-value = 0.001) with no significant difference between them (P-value = 0.22). The primary Y-BOCS score in the clonidine-treated group was 27.61 ± 8.08 versus 28.69 ± 7.44 in the control group at the baseline, which declined to 20.25 ± 6.08 versus 25.45 ± 7.35 at the end of the study, respectively. Both groups revealed a significant improvement (P-value = 0.001), but there was no statistically significant difference between them (P-value = 0.06). Drug-related complications were not statistically different between the two groups (P-value > 0.05); however, the clonidine-treated patients presented more adverse effects than control subjects. Conclusions: Although the use of clonidine posed no remarkable drug-related adverse effects, it was not superior to placebo considering symptom relief.

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).

scholarly journals Memantine augmentation of sertraline in the treatment of symptoms and executive function among patients with obsessive-compulsive disorder: A double-blind placebo-controlled, randomized clinical trial

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sanaz Askari ◽  
Saba Mokhtari ◽  
Seyed Vahid Shariat ◽  
Behnam Shariati ◽  
Masoomeh Yarahmadi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Executive 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%; however, 40–60% of OCD patients do not achieve a satisfactory response. Our main objective was to investigate the effectiveness of memantine, 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 executive function among patients with obsessive-compulsive disorder. Methods Seventy patients with OCD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria, and a Yale-Brown obsessive compulsive scale (Y-BOCS) score of more than 21 were recruited to the study. They received sertraline (100 mg daily initially followed by 200 mg daily after week 4) and either memantine (10 mg twice daily) or placebo in a placebo controlled, double-blinded, parallel-group, clinical trial of 12 weeks. The primary outcome was OCD symptoms measured by the Y-BOCS. Moreover, executive function of participants was measured by the Wisconsin Card Sorting Test (WCST). Results The total score, and obsession and compulsion subscales of Y-BOCS significantly dropped in both groups with no significant difference between the two groups. However, memantine group showed a greater response in the number of completed categories subscale of the WCST (p value<0.001). We did not observe any major adverse effects in any of the groups. Conclusion Memantine has an acceptable safety and tolerability in patients with OCD and might have a positive effect on their executive function. Nevertheless, the current results don`t support the efficacy of memantine as an adjunctive agent to sertraline for symptoms in patients with OCD. Trial registration The trial was registered at the Iranian Registry of Clinical Trials on 04/10/2019 (www.irct.ir; IRCT ID: IRCT20170123032145N4).

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

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.

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