Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis

BMC Pharmacology and Toxicology

Leila Kamalzadeh¹  Shayan Kashefinejad¹  Mohammadreza Shalbafan²  Saba Hoobehfekr³  Fatemeh Hadi⁴ 

[1]Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

[2]Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

[3]Brain and Cognition Clinic, Institute for Cognitive Sciences Studies, Tehran, Iran

[4]Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran

[5]School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

关键词: Glutamate;    Riluzole;    Memantine;    Minocycline;    Obsessive-compulsive disorder;    Systematic review;   

DOI  :  10.1186/s40360-021-00534-6

来源: Springer

【 摘 要 】

BackgroundObsessive-compulsive disorder (OCD) is among the most disabling neuropsychiatric conditions characterized by the presence of repetitive intrusive thoughts, impulses, or images (obsessions) and/or ritualized mental or physical acts (compulsions). Serotonergic medications, particularly Selective Serotonin Reuptake Inhibitors (SSRIs), are the first-line treatments for patients with OCD. Recently, dysregulation of glutamatergic system has been proposed to be involved in the etiology of OCD. We designed this systematic review and meta-analysis to evaluate clinical efficacy of glutamatergic medications in patients with OCD, according to the guidelines of Cochrane collaboration.MethodWe searched Medline, Scopus, and Cochrane library without applying any language filter. Two of the authors independently reviewed search results for irrelevant and duplicate studies and extracted data and assessed methodological quality of the studies. We transformed data into a common rubric and calculated a weighted treatment effect across studies using Review Manager.ResultsWe found 476 references in 3 databases, and after exclusion of irrelevant and duplicate studies, 17 studies with total number of 759 patients with OCD were included. In the present review we found evidence for several drugs such as memantine, N-acetylcysteine (NAC), Minocycline, L-carnosine and riluzole. Glutamaterigic drug plus SSRIs were superior to SSRI+ Placebo with regard to Y-BOCS scale [standardized mean difference (SMD = − 3.81 95% CI = − 4.4, − 3.23).ConclusionAugmentation of glutamatergic medications with SSRIs are beneficial in obsessive-compulsive patients, no harmful significant differences in any safety outcome were found between the groups.

【 授权许可】

CC BY