Fluvoxamine combination therapy with tropisetron for obsessive-compulsive disorder patients: A placebo-controlled, randomized clinical trial

Abstract

Background: About 50% of obsessive-compulsive disorder patients still suffer significant symptoms even after the recommended first-line therapy. This demonstrates the necessity to investigate strategies to improve alleviation of symptoms. Objective: The main objective of this study was to investigate the efficacy of a 5-hydroxytryptophan 3 receptor antagonist, tropisetron, as an adjuvant therapy to selective serotonin reuptake inhibitors, in ameliorating obsessive-compulsive disorder symptoms. Methods: Men and women between the ages of 18–60 years diagnosed with obsessive-compulsive disorder, based on DSM5, who had a Yale-Brown obsessive compulsive scale score of more than 21 were recruited in a double-blinded, parallel-group, placebo-controlled, clinical trial of 10 weeks to receive either tropisetron (5 mg twice daily) and fluvoxamine (100 mg daily initially followed by 200 mg daily after week 4) or placebo and fluvoxamine. The primary outcome of interest in this study was the Yale-Brown obsessive compulsive scale total score decrease from baseline. Results: One hundred and eight participants were equally randomized into two groups; 48 participants in each group finished the trial. The Yale-Brown obsessive compulsive total score significantly dropped in both groups while the tropisetron group participants experienced a significantly higher decrease in their scores (Greenhouse-Geisser F(1.53–65.87)=3.516, p-value=0.04). No major adverse effect was observed in any of the groups. Conclusion: This trial showed a significant efficacy for tropisetron over placebo in treatment of obsessive-compulsive disorder symptoms when added to fluvoxamine.

The state of psychiatric research in the Asia Pacific region

“…Recent clinical neuroscience endeavors include clinical trials with novel medications (Araminia et al, 2020; Shalbafan, Malekpour, et al, 2019), neurocognitive and neuroimaging assessments in psychiatric patients (Bagherzadeh‐Azbari et al, 2019), and neuro‐stimulation modalities amongst psychiatric patients, and have yielded numerous publications in international journals.…”

Memantine Augmentation of Sertraline in Severity of Symptoms and Cognitive Function Among Patients with Obsessive-Compulsive Disorder: A Double-Blind Placebo-Controlled, Randomized Clinical Trial

“…This clinician-rated scale contains 10 questions, each item rated from 0 (no symptoms) to 4 (extreme symptoms) (37). The psychometric properties of the Persian version of Y-BOCS are approved in previous studies (14,16,36).…”

“…Apart from the public health impact, OCD also results in a considerable economic burden (12). Currently, selective serotonin reuptake inhibitors (SSRIs) and/or cognitive behavioral therapy (CBT), are considered to be rst-line treatments for OCD (13,14). Notwithstanding the effectiveness of CBT as a non-pharmacological treatment, it has several disadvantages such as delayed clinical response, limited access, and high cost (15).…”

Memantine augmentation of sertraline in the treatment of symptoms and executive function among patients with obsessive-compulsive disorder: A double-blind placebo-controlled, randomized clinical trial

“…Currently, selective serotonin reuptake inhibitors (SSRIs) and/or cognitive behavioral therapy (CBT), are considered to be first-line treatments for OCD [ 22 , 23 ]. Notwithstanding the effectiveness of CBT as a non-pharmacological treatment, it has several disadvantages such as delayed clinical response, limited access, and high cost [ 24 ].…”