Lamotrigine as an augmentation agent in treatment-resistant obsessive-compulsive disorder: a case report

Abstract

Obsessive-compulsive disorder (OCD) is a relatively common, often chronic and disabling disorder with high rates of partial and/or absent response to standard, recommended treatments. We report a case of treatment-resistant OCD that was successfully treated with a pharmacological augmentation of lamotrigine plus clomipramine. The patient, a 59-year-old woman, was on a stable dose of clomipramine (225 mg/day) when she was started on lamotrigine (up to 150 mg/day). After 10 weeks of this treatment, her clinical condition remarkably improved, as indicated by a significant decrease of the Yale-Brown Obsessive-Compulsive Scale. This case suggests some preliminary evidence that the addition of glutamatergic agent lamotrigine may be useful in treatment-resistant OCD. However, further controlled studies are needed to support this finding.

Sarcosine Therapy for Obsessive Compulsive Disorder

“…Preliminary case reports and case series showed that resistant OCD symptoms may benefit from adjunctive nonselective glutamatergic inhibitors such as riluzole, 6,8,9 topiramate, 10 and lamotrigine. 11,12 In preliminary study, memantine, a weak uncompetitive NMDA receptor (NMDAR) antagonist, proved to be efficacious as add-on treatment to resistant OCD. 13,14 Meanwhile, Greenberg et al 7 conducted a randomized trial using glycine, a co-agonist for the activation of NMDAR complex, 15,16 as adjunctive treatment for refractory OCD.…”

Avances en el tratamiento farmacológico del trastorno obsesivo-compulsivo.

“…La lamotrigina ha mostrado eficacia al agregarse a un ISRS en pacientes resistentes de acuerdo a dos EADCCP (36,37), a un trabajo retrospectivo (38) y a reportes de casos (39,40). Asimismo, la adición de pregabalina es útil en pacientes con TOC resistente a la combinación de ISRS y antipsicóticos atípicos de acuerdo a un estudio abierto (41).…”

Topiramate augmentation in a patient with obsessive–compulsive disorder

“…15 Lamotrigine has been reported to be beneficial in some case reports, 16 but not in others. 17 Topiramate is an anticonvulsant with a novel chemical structure.…”