Hostname: page-component-77c89778f8-fv566 Total loading time: 0 Render date: 2024-07-18T12:38:26.621Z Has data issue: false hasContentIssue false
  • English
  • Français

Pregabalin augmentation for resistant obsessive–compulsive disorder: a double-blind placebo-controlled clinical trial

Published online by Cambridge University Press:  25 October 2019

Arash Mowla Open the ORCID record for Arash Mowla [Opens in a new window]  and
Mehrnoosh Ghaedsharaf
Arash Mowla*
Affiliation:
Substance Abuse and Mental Health Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Mehrnoosh Ghaedsharaf
Affiliation:
Substance Abuse and Mental Health Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
*
*Arash Mowla, MD, Email: mowlaar@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background and objective.

Glutamate dysfunction has been shown to be associated with pathophysiology of obsessive–compulsive disorder (OCD). Our objective is to survey the effects of pregabalin (a glutamate-modulating agent) as an augmenting treatment for resistant OCD.

Patients and methods.

In this 12-week double-blind placebo-controlled clinical trial, 56 patients with resistant OCD were randomly allocated to receive either pregabalin or placebo plus their current medication (sertraline). Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was used to evaluate the outcomes. Adverse effects were also registered.

Results.

Of the 56 patients with resistant OCD who were randomly allocated in 2 groups of pregabalin (n = 28) and placebo group (n = 28), 42 patients (22 in pregabalin group and 20 in placebo group) completed the trial. Throughout the trial, the mean score decreased from 26.13± 7.03 to 8.81 ± 3.47 in the pregabalin group (p < 0) and from 26.85 ± 4.34 to 17.63 ± 4.22 in the placebo group (p < 0). At the end of trial, 16 (57.14%) patients in the pregabalin group and 2 (7.14%) patients in the placebo group showed more than 35% decline in YBOCS (p < .01). The pregabalin group showed good tolerability and safety.

Conclusions.

Our study revealed that pregabalin, as an augmenting medication, is more effective than placebo in the treatment of patients with resistant OCD.

Keywords

Pregabalinobsessive–compulsive disorderglutamate
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 4 , August 2020 , pp. 552 - 556
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kessler, RC, Berglund, P, Demler, O, et al.Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.Google Scholar
Ruscio, AM, Stein, DJ, Chiu, WT, Kessler, RCThe epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.Google Scholar
Eddy, KT, Dutra, L, Bradley, R, Westen, D.A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clin Psychol Rev. 2004;24(8):1011–1030.Google Scholar
Franklin, ME, Foa, EBTreatment of obsessive compulsive disorder. Annu Rev Clin Psychol. 2011;7:229–243.Google Scholar
Pittenger, C, Bloch, M.Pharmacological treatment of obsessive-compulsive disorder. Psychiatr Clin North Am. 2014;37(3):375–391.Google Scholar
Barth, M, Kriston, L, Klostermann, S, et al.Efficacy of selective serotonin reuptake inhibitors and adverse events: meta-regression and mediation analysis of placebo-controlled trials. Br J Psychiatry. 2016;208(2):114–119.Google Scholar
Zhou, DD, Zhou, XX, Li, Y, et al.Augmentation agents to serotonin reuptake inhibitors for treatment-resistant obsessive-compulsive disorder: a network meta-analysis . Prog Neuropsychopharmacol Biol Psychiatry. 2019;90:277–287.Google Scholar
Albert, U, Marazziti, D, Di Salvo, G, et al.A systematic review of evidence based treatment strategies for obsessive-compulsive disorder resistant to first-line Pharmacotherapy. Curr Med Chem. 2018;25(41):5647–5661.Google Scholar
Shoja Shafti, S, Kaviani, H. Aripiprazole versus quetiapine in treatment-resistant obsessive-compulsive disorder: a double-blind clinical trial. Ther Adv Psychopharmacol . 2015;5(1):32–37.Google Scholar
Hollander, E, Baldini Rossi, N, Sood, E, Pallanti, S.Risperidone augmentation in treatment-resistant obsessive-compulsive disorder: a double-blind, placebo-controlled study. Int J Neuropsychopharmacol. 2003;6(4):397–401.Google Scholar
Koran, LM, Ringold, AL, Elliott, MA. Olanzapine augmentation for treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry. 2000;61(7):514–517.Google Scholar
Zareba, G.Pregabalin: a new agent for the treatment of neuropathic pain. Drugs Today. 2005;41(8):509–516.Google Scholar
Martinotti, G.Pregabalin in clinical psychiatry and addiction: pros and cons. Expert Opin Investig Drugs. 2012;21(9):1243–1245.Google Scholar
Oulis, P, Konstantakopoulos, G.Efficacy and safety of pregabalin in the treatment of alcohol and benzodiazepine dependence. Expert Opin Investig Drugs. 2012;21(7):1019–1029.Google Scholar
Dooley, DJ, Mieske, CA, Borosky, SAInhibition of K(+)-evoked glutamate release from rat neocortical and hippocampal slices by gabapentin, Neurosci Lett. 2000;280(2):107–110.Google Scholar
Chen, Y, Meng, Z, Zhang, Z, et al.The right thalamic glutamate level correlates with functional connectivity with right dorsal anterior cingulate cortex/middle occipital gyrus in unmedicated obsessive-compulsive disorder: a combined fMRI and 1H-MRS study. Aust N Z J Psychiatry. 2019;53(3):207–218.Google Scholar
Chakrabarty, K, Bhattacharyya, S, Christopher, R, Khanna, S.Glutamatergic dysfunction in OCD. Neuropsychopharmacology. 2005;30(9):1735–1740.Google Scholar
Grados, MA, Atkins, EB, Kovacikova, GI, McVicar, E.A selective review of glutamate pharmacological therapy in obsessive-compulsive and related disorders. Psychol Res Behav Manag. 2015;8:115–131Google Scholar
Grant, PJ, Joseph, LA, Farmer, CA, et al.12-week, placebo-controlled trial of add-on riluzole in the treatment of childhood-onset obsessive compulsive disorder. Neuropsychopharmacology. 2014;39(6):1453–1459Google Scholar
Mowla, A, Sahraian, A, et al.Topiramate augmentation in resistant OCD: a double-blind placebo-controlled clinical trial. CNS Spectr. 2010;15(11):613–617.Google Scholar
Sahraian, A, Jahromi, LR, Ghanizadeh, A, Mowla, A. Memantine as an adjuvant treatment for obsessive compulsive symptoms in manic phase of bipolar disorder: a randomized, double-blind, placebo-controlled clinical trial. J Clin Psychopharmacol. 2017;37(2):246–249.Google Scholar
Bhattacharyya, S, Khanna, S, Chakrabarty, K, et al.Anti-brain autoantibodies and altered excitatory neurotransmitters in obsessive-compulsive disorder. Neuropsychopharmacology. 2009;34(12):2489–2496.Google Scholar
Oulis, P, Mourikis, I, Konstantakopoulos, G.Pregabalin augmentation in treatment-resistant obsessive-compulsive disorder. Int Clin Psychopharmacol. 2011;26(4):221–224.Google Scholar
Onder, E, Tural, U, Gökbakan, M.Does gabapentin lead to early symptom improvement in obsessive-compulsive disorder? Eur Arch Psychiatry Clin Neurosci. 2008;258(6):319–323.Google Scholar
Mowla, A, Kalantarhormozi, MR, Khazraee, S. Clinical characteristics of patients with major depressive disorder with and without hypothyroidism: a comparative study. J Psychiatr Pract. 2011;17(1):67–71.Google Scholar
Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–1011.Google Scholar
Sahraian, A, Bigdeli, M, Ghanizadeh, A, Akhondzadeh, S.Topiramate as an adjuvant treatment for obsessive compulsive symptoms in patients with bipolar disorder: a randomized double blind placebo controlled clinical trial. J affect disord. 2014;166:201–205.Google Scholar
Sahraian, A, Ehsaei, Z, Mowla, A.Aripiprazole as an adjuvant treatment for obsessive and compulsive symptoms in manic phase of bipolar disorder: a randomized, double-blind, placebo-controlled clinical trial. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Pt A):267–271.Google Scholar
Parent, A, Hazrati, LNFunctional anatomy of the basal ganglia. I. The cortico-basal ganglia-thalamocortical loop. Brain Res Brain Res Rev. 1995;20(1):91–127.Google Scholar
Ting, JT, Feng, G.Glutamatergic synaptic dysfunction and obsessive-compulsive disorder. Curr Chem Genomics. 2008;2:62–75.Google Scholar
Wu, K, Hanna, GL, Rosenberg, DR, Arnold, PDThe role of glutamate signaling in the pathogenesis and treatment of obsessive-compulsive disorder. Pharmacol Biochem Behav. 2012;100(4):726–735.Google Scholar
Stewart, SE, Jenike, EA, Hezel, DM, et al.A single-blinded case control study of memantine in severe obsessive-compulsive disorder. J Clin Psychopharmacol. 2010;30(1):34–39.Google Scholar
Bruno, A, Micò, U, Pandolfo, G, et al.Lamotrigine augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive compulsive disorder: a double-blind, placebo-controlled study. J Psychopharmacol. 2012;26(11):1456–1462.Google Scholar
Hollander, E, Dell’Osso, B.Topiramate plus paroxetine in treatment resistant obsessive-compulsive disorder. Int Clin Psychopharmacol. 2006;21(3):189–191.Google Scholar
Pasquini, M, Berardelli, I, Biondi, M.Amantadine augmentation for refractory obsessive-compulsive disorder: a case report. J Clin Psychopharmacol. 2010;30(1):85–86.Google Scholar
Rodriguez, CI, Kegeles, LS, Flood, P, Simpson, HBRapid resolution of obsessions after an infusion of intravenous ketamine in a patient with treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry. 2011;72(4):567–569.Google Scholar
Greenberg, WM, Benedict, MM, Doerfer, J, et al.Adjunctive glycine in the treatment of obsessive-compulsive disorder in adults. J Psychiatr Res. 2009;43(6):664–670.Google Scholar
Wilhelm, S, Buhlmann, U, Tolin, DF, et al.Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder. Am J Psychiatry. 2008;165(3):335–341.Google Scholar
Boschen, MJ, Drummond, LM, Pillay, A.Treatment of severe, treatment-refractory obsessive-compulsive disorder: a study of inpatient and community treatment. CNS Spectr. 2008;13(12):1056–1065.Google Scholar
Sousa, MB, Isolan, LR, Oliveira, RR, et al.A randomized clinical trial of cognitive-behavioral group therapy and sertraline in the treatment of obsessive-compulsive disorder. J Clin Psychiatry. 2006;67(7):1133– 1139.Google Scholar