Comparing the efficacy of ondansetron and granisetron augmentation in treatment-resistant obsessive-compulsive disorder

Sharafkhah, Mojtaba; Alamdar, Mobina Aghakarim; Massoudifar, Ali; Abdolrazaghnejad, Ali; Ebrahimi-Monfared, Mohsen; Saber, Reza; Mohammadbeigi, Abolfazl

doi:10.1097/yic.0000000000000267

Cited by 14 publications

(17 citation statements)

References 34 publications

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“…In the same vein, Sharafkhani et al (2019) reported the e cacy of granisetron in patients with treatmentresistant OCD in a 14-week trial in comparison with the ondansetron arm and placebo arm. Although they reported the e cacy of granisetron in the treatment of the patients, they concluded that ondansetron is a superior option to granisetron (19). The results of their study are hardly comparable to ours because the present study was performed on patients with moderate to severe OCD, not treatment-resistant patients.…”

Section: Discussioncontrasting

confidence: 65%

“…Recent evidence suggests that ondansetron and tropisetron, other members of the 5-HT 3 receptor antagonist family, have been successfully used to treat OCD (12,(16)(17)(18). So far, only two studies have attempted to investigate the e cacy of granisetron for the treatment of OCD (15,19). Overall, the results of these studies supported the potential e cacy and safety of 5-HT 3 receptor antagonists for the treatment of patients with OCD.…”

Section: Introductionmentioning

confidence: 91%

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Granisetron Augmentation of Sertraline in Obsessive-Compulsive Disorder: A Double-Blind Placebo-Controlled, Randomized Clinical Trial

Ghobadian

Mokhtari

Shariati

et al. 2022

Preprint

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Background: Medications currently recommended for the treatment of Obsessive-Compulsive Disorder (OCD) usually relieve the severity of symptoms by as much as 20–30%, and satisfactory treatment is obtained in 40–60% of patients with OCD. Nevertheless, the remaining symptoms continue to impair the patients’ function. Therefore, it is necessary to investigate possible strategies to improve the mitigation of symptoms.In this study, the main objective was to examine and investigate the effectiveness of granisetron, which is a serotonin 5-hydroxytryptamine receptor type 3 (5-HT3) antagonist, as an adjunct therapy to selective serotonin reuptake inhibitors, for the purpose of ameliorating OCD symptoms. Methods: fifty-eight patients diagnosed with OCD, based on Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, who had a Yale-Brown obsessive-compulsive scale (Y-BOCS) score of more than 21 were recruited in a double-blinded, parallel-group, placebo-controlled, clinical trial of 10 weeks to receive either granisetron (1 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.Results: Y-BOCS total score significantly dropped in both groups (28.9 to 17.7 for granisetron and 27.5 to 19.3 for placebo group with a slightly greater drop for granisetron group), while the granisetron group experienced a significantly greater reduction in obsession scores (Greenhouse-Geisser F(2.32,97.57)=4.52,p-value=0.01). Moreover, in comparison with the placebo group, the proportion of the patients showing complete response was considerably higher among the granisetron group (P-value <0.01). No major adverse effects were observed in any of the groups. Conclusion: The results suggest that granisetron augmentation of sertraline may increase the rate of response in patients with moderate to severe non-refractory OCD. Further studies are suggested in this regard.Trial registration: The trial was registered at the Iranian Registry of Clinical Trials on 27/03/2019 (www.irct.ir; IRCT ID: IRCT20170123032145N3).

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Section: Discussioncontrasting

confidence: 65%

Section: Introductionmentioning

confidence: 91%

Granisetron Augmentation of Sertraline in Obsessive-Compulsive Disorder: A Double-Blind Placebo-Controlled, Randomized Clinical Trial

Ghobadian

Mokhtari

Shariati

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In the same vein, Sharafkhani et al (2019) reported the efficacy of granisetron in patients with treatment-resistant OCD in a 14-week trial in comparison with the ondansetron arm and placebo arm. Although they reported the efficacy of granisetron in the treatment of the patients, they concluded that ondansetron is a superior option to granisetron[ 19 ]. The results of their study are hardly comparable to ours because the present study was performed on patients with moderate to severe OCD, not treatment-resistant patients.…”

Section: Discussionmentioning

confidence: 99%

“…Even if, some previous studies have shown positive effects of the 5-HT 3 receptor antagonists (e,g., ondansetron and granisetron) in augmentation with SSRIs on OCD-related symptoms [15][16][17] and recent evidence suggests that ondansetron and tropisetron (other members of the 5-HT 3 receptor antagonist family) have been successfully used to treat OCD [12,[16][17][18], no animal OCD models have directly implicated 5-HT 3 receptors and only two studies have attempted to investigate the efficacy of granisetron for the treatment of OCD [15,19]. Despite this, the results of these studies supported the potential efficacy and safety of 5-HT 3 receptor antagonists for the treatment of patients with OCD.…”

Section: Introductionmentioning

confidence: 99%

Granisetron-mediated augmentation of sertraline therapeutic effect in obsessive-compulsive disorder: a double-blind placebo-controlled, randomized clinical trial

Ghobadian

Mokhtari

Shariati

et al. 2022

BMC Pharmacol Toxicol

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Background Medications currently recommended for the treatment of Obsessive-Compulsive Disorder (OCD) usually relieve the severity of symptoms by as much as 20–30%, and satisfactory treatment is obtained in 40–60% of patients with OCD. Nevertheless, the remaining symptoms continue to impair the patients’ function. Therefore, it is necessary to investigate possible strategies to improve the mitigation of symptoms. In this study, the main objective was to examine and investigate the effectiveness of granisetron, which is a serotonin 5-hydroxytryptamine receptor type 3 (5-HT3) antagonist, as an adjunct therapy to selective serotonin reuptake inhibitors, for the purpose of ameliorating OCD symptoms. Methods fifty-eight patients diagnosed with OCD, based on Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, who had a Yale-Brown obsessive-compulsive scale (Y-BOCS) score of more than 21 were recruited in a double-blinded, parallel-group, placebo-controlled, clinical trial of 10 weeks to receive either granisetron (1 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. Results Y-BOCS total score significantly dropped in both groups (28.9 to 17.7 for granisetron plus sertraline and 27.5 to 19.3 for placebo plus sertraline group with a slightly greater drop for granisetron plus sertraline group), while the granisetron plus sertraline group experienced a significantly greater reduction in obsession scores (Greenhouse-Geisser F(2.32,97.57) = 4.52,p-value = 0.01). Moreover, in comparison with the placebo plus sertraline group, the proportion of the patients showing complete response was considerably higher among the granisetron plus sertraline group (P-value < 0.01). No major adverse effects were observed in any of the groups. Conclusion The results suggest that granisetron augmentation of sertraline may increase the rate of response in patients with moderate to severe non-refractory OCD. Further studies are suggested in this regard.

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“…Through 5-HT3 blockade, these drugs have a weak downstream inhibitory effect on dopaminergic neurotransmission. Ondansetron has been found to be effective in both uncontrolled and placebo-controlled trials [28,29], but the experience with ondansetron in our clinic has not been encouraging [30]. At best, 5HT-3 antagonists may be viewed as experimental treatments needing confirmation in larger studies.…”

Section: Other Augmenting Agentsmentioning

confidence: 99%

Are current pharmacotherapeutic strategies effective in treating OCD?

Reddy

Arumugham

2020

Expert Opinion on Pharmacotherapy

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Comparing the efficacy of ondansetron and granisetron augmentation in treatment-resistant obsessive-compulsive disorder

Cited by 14 publications

References 34 publications

Granisetron Augmentation of Sertraline in Obsessive-Compulsive Disorder: A Double-Blind Placebo-Controlled, Randomized Clinical Trial

Granisetron Augmentation of Sertraline in Obsessive-Compulsive Disorder: A Double-Blind Placebo-Controlled, Randomized Clinical Trial

Granisetron-mediated augmentation of sertraline therapeutic effect in obsessive-compulsive disorder: a double-blind placebo-controlled, randomized clinical trial

Are current pharmacotherapeutic strategies effective in treating OCD?

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