12-Week, Placebo-Controlled Trial of Add-on Riluzole in the Treatment of Childhood-Onset Obsessive–Compulsive Disorder

Grant, Paul; Joseph, Lisa; Farmer, Cristan; Luckenbaugh, David A.; Lougee, Lorraine; Zarate, Carlos A.; Swedo, Susan E.

doi:10.1038/npp.2013.343

Cited by 64 publications

(46 citation statements)

References 31 publications

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“…Although uncontrolled studies had previously shown effects in children [101] and adults [102,103], the first RCT trial conducted among (S)SRI non-responders did not show any effect over pill placebo. However, 28 % of participants had concomitant autism disorder [104].…”

Section: Medicationsmentioning

confidence: 98%

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Skarphéðinsson

Ivarsson

2015

Curr Behav Neurosci Rep

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Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling, and common disorder. In this paper, we describe evidence-based treatments in treatment-naïve and treatment-refractory pediatric OCD patients. We conducted a PubMed search to identify randomized controlled trials, reviews, and expert guidelines. The evidence for cognitive behavior therapy (CBT) and specific serotonin reuptake inhibitors (SSRIs) among treatment-naïve patients is substantial and shows that both treatments are effective. Head-to-head trials in pediatric OCD only show that CBT is significantly more effective than SSRI. The evidence among CBT and SSRI non-responders is limited. One trial among CBT non-responders showed that both continued CBT and switching to an SSRI are effective strategies. Likewise, one trial among SSRI non-responders showed that augmenting with CBT is necessary. Evidence of treatments for treatment-refractory pediatric OCD is lacking. We describe the treatments available and evidence from studies of adult OCD. Evidence for emerging treatments such as modifying CBT and glutamatergic drugs is also described.

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Section: Medicationsmentioning

confidence: 98%

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Skarphéðinsson

Ivarsson

2015

Curr Behav Neurosci Rep

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“…Riluzole has shown some positive clinical responses in refractory OCD patients [114] . However, in more controlled studies, results have shown only minimal benefits [115,116] .…”

Section: Glutamatementioning

confidence: 99%

Effect of Gonadal Hormones on Neurotransmitters Implicated in the Pathophysiology of Obsessive-Compulsive Disorder: A Critical Review

Karpinski

Mattina

Steiner³

2016

Neuroendocrinology

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Obsessive-compulsive disorder (OCD) is a relatively common neuropsychiatric disorder affecting between 1.6 and 3.2% of the population. A number of studies have previously reported increased incidence of OCD, or exacerbation of preexisting symptoms in females during reproductive events. Since these periods are known to involve fluctuating levels of gonadal hormones, these steroids have been suggested to be involved in modulating the course of the disorder. However, to date, only a few studies have measured hormone levels and obsessive-compulsive (OC) symptoms concurrently; thus, direct evidence for this relationship is limited. In turn, investigations into neurotransmission in OC individuals have been more extensive, and have implicated the serotonergic, dopaminergic, and glutamatergic neurotransmitter systems in OCD pathology. There is evidence suggesting that reproductive hormones estrogens and progesterone can modulate neurotransmission in the aforementioned signaling pathways by regulating the expression of receptors and channels, as well as the synthesis and release of the neurotransmitter itself. Overall, estrogen and progesterone appear to enhance serotonin signaling, which has been associated with improved OC symptoms. The effect of the gonadal hormones in dopaminergic and glutamatergic signaling is much more variable, highlighting the need for further research in this field. The existing evidence shows that gonadal hormones can have profound impacts on neurotransmission in the brain, leading to the conclusion that the hormonal fluctuations during reproductive events are a plausible factor contributing to the change in OCD course during these times.

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“…Por último, algunas investigaciones abiertas sugirieron que el riluzol, un modulador del glutamato, podría mejorar el TOC resistente en pacientes adultos (58) y menores de edad (59); sin embargo, los resultados de posteriores estudios controlados con placebo son dudosos en adultos (60) y negativos en niños (61 Rev Neuropsiquiatr 79 (4), 2016.…”

Section: Fármacos Relacionados a La Función Glutamatérgicaunclassified

Avances en el tratamiento farmacológico del trastorno obsesivo-compulsivo.

Vega‐Dienstmaier¹

2017

Rev Neuropsiquiatr

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RESUMENLos antidepresivos serotoninérgicos, la farmacoterapia de primera línea para el trastorno obsesivo-compulsivo (TOC), producen una respuesta clínica favorable en 40-60% de los pacientes. Los medicamentos con eficacia en el tratamiento del TOC, según los diversos mecanismos de acción, son: 1) sustancias que influyen sobre la serotonina: antidepresivos serotoninérgicos (inhibidores selectivos de la recaptación de serotonina y clomipramina), bloqueadores de los receptores 5-HT 3 (ondansetrón y granisetrón) y antagonistas 5-HT 1A (pindolol); 2) antipsicóticos: aripiprazol, risperidona y haloperidol; 3) anticonvulsivantes / estabilizadores del ánimo: lamotrigina; 4) fármacos relacionados con la función glutamatérgica: memantina, N-acetilcisteína y ketamina; 5) anti-inflamatorios: celecoxib; 6) opiáceos: morfina; 7) fármacos que aumentan la función colinérgica; y 8) anti-andrógenos. Es de esperarse que en el futuro crezca el repertorio de alternativas farmacológicas para el tratamiento de esta entidad clínica.PALABRAS CLAVE: Trastorno obsesivo-compulsivo, tratamiento farmacológico, agentes serotoninérgicos, antipsicóticos, función glutamatérgica. SUMMARYSerotoninergic antidepressants, the first line of pharmacotherapy for obsessive-compulsive disorder (OCD), induce a favorable clinical response in 40-60% of patients. Drugs that have shown efficacy for OCD treatment, on the basis of different mechanisms of action, are: 1) substance that work on serotonin: serotoninergic antidepressants (selective serotonin reuptake inhibitors and clomipramine), 5-HT 3 receptor blockers (ondansetron and granisetron), and 5-HT 1A antagonists (pindolol); 2) antipsychotic drugs: aripiprazole, risperidone and haloperidol; 3) anticonvulsant drugs / mood stabilizers: lamotrigine; 4) glutamatergic function-related drugs: memantine, N-acetylcysteine and ketamine; 5) anti-inflammatory drugs: celecoxib; 6) opioid drugs: morphine; 7) drugs that increase cholinergic function; 8) anti-androgen drugs. The repertoire of pharmacological alternatives for the treatment of OCD is expected to grow in the future.

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12-Week, Placebo-Controlled Trial of Add-on Riluzole in the Treatment of Childhood-Onset Obsessive–Compulsive Disorder

Cited by 64 publications

References 31 publications

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Evidence-Based Treatments in Treatment-Naïve and Treatment-Resistant Pediatric Obsessive-Compulsive Disorder

Effect of Gonadal Hormones on Neurotransmitters Implicated in the Pathophysiology of Obsessive-Compulsive Disorder: A Critical Review

Avances en el tratamiento farmacológico del trastorno obsesivo-compulsivo.

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