Evaluation of Clonidine Augmentation Therapy for Obsessive-Compulsive Disorder Treatment; a Randomized Clinical Trial

Abstract

Background: Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder worldwide. Inadequate response of OCD patients to a usual agent makes this disorder a great challenge, and recent studies have recommended augmentation therapy as a new choice. Objectives: As traces of noradrenergic dysfunction have been noted in OCD pathophysiology, the current study aimed to assess the efficacy of clonidine augmentation therapy for treating OCD. Methods: This was a randomized clinical trial conducted on 57 OCD patients divided into the two groups of 1-mg clonidine augmentation therapy (n = 28) and placebo group (n = 29). The medication was administered for 12 weeks. Patients’ primary treatment, including SSRIs or clomipramine, continued by receiving the same dose used before participation in this study. The Yale-Brown Obsessive-Compulsive scale (Y-BOCS) and Clinical Global Impression-Severity scale (CGI-S) were used to assess the patients at the start of the study and then at four-week intervals. Drug-related adverse effects and global improvement were assessed and compared between the two groups. Results: The initial CGI scores were 3.89 ± 1.57 and 4.10 ± 1.61 at the baseline and 2.29 ± 1.18 and 3.07 ± 1.51 at the end of the study in the intervention and control groups, respectively. Both groups revealed a significant improvement (P-value = 0.001) with no significant difference between them (P-value = 0.22). The primary Y-BOCS score in the clonidine-treated group was 27.61 ± 8.08 versus 28.69 ± 7.44 in the control group at the baseline, which declined to 20.25 ± 6.08 versus 25.45 ± 7.35 at the end of the study, respectively. Both groups revealed a significant improvement (P-value = 0.001), but there was no statistically significant difference between them (P-value = 0.06). Drug-related complications were not statistically different between the two groups (P-value > 0.05); however, the clonidine-treated patients presented more adverse effects than control subjects. Conclusions: Although the use of clonidine posed no remarkable drug-related adverse effects, it was not superior to placebo considering symptom relief.

Antihypertensive drugs and brain function: mechanisms underlying therapeutically beneficial and harmful neuropsychiatric effects

“…Other off-label use of clonidine includes the management of obsessive-compulsive disorder (OCD) symptoms 54 and clinically relevant sleep problems in paediatric patients affected by neurodevelopmental disorders. 55 Clonidine has been also successfully used in monotherapy for hallucinations in adults with schizophrenia, 56–58 although its mechanism of antipsychotic effect remains hypothetical.…”

Predicting the Severity of Obsessive-compulsive Symptoms Based on Traumatic Childhood Experiences: The Mediating Role of Self-criticism

“…OCD ranks fourth among the most common psychiatric disorders and has a prevalence of 1.3% (Fawcett et al, 2020;Sachs & Erfurth, 2018). The most common comorbid disorders with OCD are social anxiety disorder (14%), major depressive disorder (15%), and generalized anxiety disorder (13%) (Akouchakian et al, 2021;Van Oudheusden et al, 2020).…”