The Brown UniversiTy Child & AdolesCenT PsyChoPhArmACology UPdATe 7 thorough medical evaluation. Parents were also carefully interviewed and were requested to rate the severity of the ADHD-RS-IV symptoms based on the behavior of their children at home. Among the exclusion criteria was use of any medication that might have adverse reactions with saffron, including warfarin, aspirin, other antiplatelet agents, and herbal medicines (such as garlic, feverfew, ginseng, dong quai, red clover, and other natural coumadins). One group received methylphenidate (Ritalin), and the second received saffron capsules.

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On the basis of numerous previous studies, the serotonergic system plays a role in the pathogenesis of obsessive-compulsive disorder (OCD) and effective agents in this pathway, such as 5-hydroxytryptophan, can potentially contribute to treatment of patients with this disorder. Evaluating the efficacy of 5-hydroxytryptophan in treating OCD was the aim of the present randomized, double-blind, placebo-controlled 12-week trial. In a 12-week, randomized double-blind study, 60 patients with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of moderate to severe OCD and a Yale–Brown Obsessive Compulsive Scale (Y-BOCS) score of >21 were randomly assigned to receive either fluoxetine plus placebo or fluoxetine plus 5-hydroxytryptophan (100 mg twice daily). All patients, regardless of their treatment group, received fluoxetine at 20 mg/day for the initial 4 weeks of the study followed by 60 mg/day of fluoxetine for the rest of the trial course. Symptoms were assessed using the Y-BOCS at baseline and weeks 4, 8 and 12. General linear model repeated measure showed significant effects for time × treatment interaction on total Y-BOCS (F = 12.07, df = 2.29, P-value <0.001), obsession (F = 8.25, df = 1.91, P-value = 0.001) and compulsion subscale scores (F = 6.64, df = 2.01, P-value = 0.002). 5-Hydroxytryptophan augmentation therapy demonstrated higher partial and complete treatment response rate (P = 0.032 and P = 0.001, respectively) according to the Y-BOCS total scores. The results of this study confirm that 5-hydroxytryptophan may be effective as an augmentative agent in treatment of moderate-to-severe OCD.

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Aim The role of the glutamatergic system in the pathogenesis of obsessive–compulsive disorder (OCD) has been shown by numerous studies. The aim of the present randomized, double‐blind, placebo‐controlled, 12‐week trial was to assess the efficacy and tolerability of amantadine as an adjuvant to fluvoxamine in the treatment of patients with moderate to severe OCD. Methods One hundred patients diagnosed with moderate to severe OCD were randomized into two parallel groups to receive fluvoxamine (100 mg twice a day) plus placebo or fluvoxamine (100 mg twice a day) plus amantadine (100 mg daily) for 12 weeks. All patients received 100 mg/day fluvoxamine for 28 days followed by 200 mg/day for the rest of the trial, regardless of their treatment groups. Patients were evaluated for response to treatment using the Yale–Brown Obsessive Compulsive Scale (Y‐BOCS) at baseline and at Weeks 4, 10, and 12. The main outcome measure was to assess the efficacy of amantadine in improving the OCD symptoms. Results Repeated‐measure analysis of variance showed a significant effect for Time × Treatment interaction (Greenhouse–Geisser corrected: F = 3.84, d.f. = 1.50, P = 0.03) in the Y‐BOCS total score and a significant effect for Time × Treatment interaction (Greenhouse–Geisser corrected: F = 5.67, d.f. = 1.48, P < 0.01) in the Y‐BOCS Obsession subscale score between the two groups. Conclusion The results of this study suggest that amantadine may be effective as an augmentative agent in the treatment of moderate‐to‐severe OCD.

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