Granisetron Adjunct to Fluvoxamine for Moderate to Severe Obsessive-Compulsive Disorder

Askari, Neda; Moin, Mahdieh; Sanati, Mohammad Hossein; Tajdini, Masih; Hosseini, Saeed; Modabbernia, Amirhossein; Najand, Babak; Salimi, Samrand; Tabrizi, Mina; Ashrafi, Mandana; Hajiaghaee, Reza; Akhondzadeh, Shahin

doi:10.2165/11635850-000000000-00000

Cited by 58 publications

(58 citation statements)

References 46 publications

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“…Other agents that have been studied as adjunctive therapy for treatment-resistant OCD include celecoxib [777], granisetron [778], IV ketamine [779,780], ondansetron [784,785], N-acetylcysteine [786,787] (all Level 2), and riluzole (Level 3) [788,789]. There is little clinical experience with these agents for refractory OCD, therefore they are recommended as third-line adjunctive options only.…”

Section: Obsessive-compulsive Disordermentioning

confidence: 99%

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

et al. 2014

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BackgroundAnxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.MethodsThese guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.ResultsThese guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.ConclusionsAnxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.

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Section: Obsessive-compulsive Disordermentioning

confidence: 99%

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

et al. 2014

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“…The findings of small randomised placebocontrolled augmentation studies with 5-HT 3 antagonists provide evidence for the efficacy of the addition of ondansetron to fluoxetine [I (PCT)] (Soltani et al, 2010) and for the addition of granisetron to fluvoxamine [I (PCT)] (Askari et al, 2012). Three relatively small randomised placebo-controlled anticonvulsant augmentation studies indicate that the addition of topiramate to SSRIs reduces the severity of compulsions [I (PCT)] (Berlin et al, 2011), and of obsessive-compulsive symptoms [I (PCT)] (Mowla et al, 2010); and the addition of lamotrigine to SSRIs reduces the severity of obsessive-compulsive and affective symptoms [I (PCT)] (Bruno et al, 2012).…”

Section: Further Management After Nonresponse To Initial Treatmentmentioning

confidence: 99%

Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from the British Association for Psychopharmacology

et al. 2014

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This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees.

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“…The other strategy is augmenting an SSRI with a serotonin 5-HT 3 receptor antagonist [77]. One double-blind RCT has shown the benefits of augmenting an SSRI with granisetron in adult OCD [78], and two doubleblind RCTs have shown the benefits of ondansetron in adult OCD [79,80]. These treatments are clearly to be used by experts in true treatment-refractory OCD.…”

Section: Other Possible Medicationsmentioning

confidence: 99%

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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Granisetron Adjunct to Fluvoxamine for Moderate to Severe Obsessive-Compulsive Disorder

Abstract: IRCT201202041556N32.

Cited by 58 publications

References 46 publications

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guidelines from the British Association for Psychopharmacology

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

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