Lamotrigine augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive–compulsive disorder: a double-blind, placebo-controlled study

Abstract

The present 16-week double-blind, randomized, placebo-controlled trial had the aim to explore the efficacy of lamotrigine add-on pharmacotherapy on clinical symptomatology and cognitive functioning in a sample of patients with treatment-resistant obsessive-compulsive disorder (OCD) receiving serotonin reuptake inhibitors (SRIs). After clinical and neurocognitive assessments, patients were randomly allocated to receive, in a double-blind design, 100 mg/day of lamotrigine or a placebo. A final sample of 33 patients completed the study. The results obtained indicate that lamotrigine added to stable SRI treatment substantially improved obsessive-compulsive (Yale-Brown Obsessive Compulsive Scale: obsessions, p < 0.0001; compulsions, p < 0.0001; total score, p < 0.0001), and affective symptoms (Hamilton Rating Scale for Depression p < 0.0001). Regarding cognitive functions, improvement was observed only in Semantic Fluency (p = 0.004). The findings provide evidence that lamotrigine augmentation of SRI treatment is well tolerated and may be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant OCD.

Hoarding Symptoms Respond to Treatment for Rapid Cycling Bipolar II Disorder

“…[16][17][18][19][20] In addition, in at least 1 previous case series, it was reported that some patients with hoarding disorder responded to extended-release methylphenidate. 21 Thus, our report suggests that the treatment of bipolar depression, when present, may help patients with different types of obsessivecompulsive and related disorder symptoms, including hoarding.…”

Obsessive–compulsive disorder (OCD): Practical strategies for pharmacological and somatic treatment in adults

“…Positive results were obtained in a small randomized controlled trial of lamotrigine (Bruno et al, 2012). Randomized placebo controlled trials of topiramate augmentation resulted in a therapeutic effect (reducing compulsions only) in one study (Berlin et al, 2011) whereas another study (Mowla et al, 2010) noted significant improvement in the topiramate as opposed to the placebo group.…”

Pharmacokinetic and pharmacodynamic interactions between antiepileptics and antidepressants

“…There are few RCTs with antiepileptics in OCD, but one [121] suggests that lamotrigine may potentiate the effects of serotonergic reuptake inhibitors in treatment-resistant OCD, possibly due to its glutamatergic effects. A recent guideline recommended SSRI augmentation with lamotrigine or topiramate as one of the options after initial SSRI nonresponse in OCD [111].…”