Double-Blind, Placebo-Controlled, Pilot Trial of Paliperidone Augmentation in Serotonin Reuptake Inhibitor–Resistant Obsessive-Compulsive Disorder

Storch, Eric A.; Goddard, Andrew W.; Grant, Jon E.; Nadai, Alessandro S. De; Goodman, Wayne K.; Mutch, P. Jane; Medlock, Carla; Odlaug, Brian L.; McDougle, Christopher J.; Murphy, Tanya K.

doi:10.4088/jcp.12m08278

Cited by 37 publications

(29 citation statements)

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“…The results of the individual atypical anti-psychotics were as follows: (a) Risperidone: Five studies were identified [12,[14][15][16][17] with 77 participants in total taking risperidone and 89 receiving placebo. The overall difference was statistically significant with an overall mean reduction of 3.89 points on the Y-BOCS (95% CI = 1.43-5.48) and an effect size of D = 0.53 ( Figure 2).…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…All the studies used different definitions of recovery of either >25% [14,16] or >35% [12,15,17] reduction in Y-BOCS outcome either with or without additional criteria such as change on Clinical Global Improvement scale [12,15]. We therefore confined our categorical analysis to risperidone studies only since the previous Cochrane review [4] had conducted this analysis on other antipsychotics and there were no new studies for quietapine and olanzapine.…”

Section: Data Itemmentioning

confidence: 99%

“…However LOCF carries a risk of bias and variance of treatment effect will be underestimated as natural variation in measurement is factored out [32]. One study used intention to treat analysis as well as hot-deck imputation [23], and another used multiple imputation [17] to amend for missing data. Only multiple imputation is recommended as statistically unbiased way of dealing with missing data.…”

Section: Risk Of Bias Across the Studiesmentioning

confidence: 99%

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Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis

et al. 2014

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BackgroundIn 2006, the National Institute of Clinical and Health Excellence (NICE) guidelines for Obsessive Compulsive Disorder (OCD) recommended anti-psychotics as a class for SSRI treatment resistant OCD. The article aims to systematically review and conduct a meta-analysis on the clinical effectiveness of atypical anti-psychotics augmenting an SSRI.MethodsStudies that were double-blind randomized controlled trials of an atypical antipsychotic against a placebo, for a minimum of 4 weeks, in adults with OCD, were included. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores were the primary outcome measure. Inclusion criteria included Y-BOCS score of 16 or more and at least one adequate trial of a SSRI or clomipramine for at least 8 weeks prior to randomization. Data sources included Medline, Embase, PsycINFO, Cochrane Database of Systematic Reviews (CDSR), trial registries and pharmaceutical databases and manufacturers up to September 2013. Forest-plots were drawn to display differences between drug and placebo on the Y-BOCS.ResultsTwo studies found aripiprazole to be effective in the short-term. There was a small effect-size for risperidone or anti-psychotics in general in the short-term. We found no evidence for the effectiveness of quetiapine or olanzapine in comparison to placebo.ConclusionsRisperidone and aripiprazole can be used cautiously at a low dose as an augmentation agent in non-responders to SSRIs and CBT but should be monitored at 4 weeks to determine efficacy.

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Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Data Itemmentioning

confidence: 99%

Section: Risk Of Bias Across the Studiesmentioning

confidence: 99%

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Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis

et al. 2014

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“…Por otra parte, según estudios no controlados, el amisulpride puede ser útil para potenciar el tratamiento del TOC resistente a ISRS (28,29) y un estudio piloto controlado con placebo mostró una tendencia no significativa a favor de la paliperidona como coadyuvante en el tratamiento de TOC resistente a ISRS (30). Por último, hay reportes de casos (31,32) y un estudio no controlado (33) que sugieren utilidad de la ziprasidona en TOC resistente.…”

Section: Rev Neuropsiquiatr 79 (4) 2016unclassified

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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“…No RCTs exist that have examined the efficacy of ziprasidone. Of the newer atypical antipsychotic drugs asenapine, lurasidone, iloperidone, and paliperidone, only paliperidone has been examined in a double-blind, placebo-controlled trial, with a nonsignificant trend toward improvement in OCD symptoms (130).…”

Section: Ocd Refractory To Initial Pharmacological Managementmentioning

confidence: 99%

Obsessive-Compulsive Disorder: Diagnosis, Epidemiology, Etiology, and Treatment

Sassano-Higgins¹,

Pato²

2015

FOC

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Obsessive-compulsive disorder (OCD) has been given increased attention in DSM-5, receiving its own chapter. In this article, the authors discuss changes to the diagnostic criteria and symptoms differentiating OCD from other disorders. Two new specifiers, which have relevance in regard to treatment selection, appear in DSM-5: level of insight and presence of tic disorder. The epidemiology of OCD remains under investigation and may be modified based on the new DSM-5 criteria. Current data regarding age of onset and social and occupational functioning of patients with OCD are presented. The structural and functional neuroanatomy of OCD has been an area of increased research attention, and the authors summarize the research in this area. Treatment of OCD remains difficult, involving a combination of pharmacotherapy and cognitivebehavorial therapy, with a large percentage of nonresponders to initial treatment. The authors review pharmacotherapy recommendations from the APA practice guidelines and discuss evidence for pharmaceutical options. Surgical treatment is a promising option, and the authors review evidence for various procedures.

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Double-Blind, Placebo-Controlled, Pilot Trial of Paliperidone Augmentation in Serotonin Reuptake Inhibitor–Resistant Obsessive-Compulsive Disorder

Abstract: ClinicalTrials.gov identifier: NCT00632229.

Cited by 37 publications

References 0 publications

Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis

Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis

Avances en el tratamiento farmacológico del trastorno obsesivo-compulsivo.

Obsessive-Compulsive Disorder: Diagnosis, Epidemiology, Etiology, and Treatment

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