Pregabalin augmentation for resistant obsessive–compulsive disorder: a double-blind placebo-controlled clinical trial

Abstract

Background and objective.Glutamate dysfunction has been shown to be associated with pathophysiology of obsessive–compulsive disorder (OCD). Our objective is to survey the effects of pregabalin (a glutamate-modulating agent) as an augmenting treatment for resistant OCD.Patients and methods.In this 12-week double-blind placebo-controlled clinical trial, 56 patients with resistant OCD were randomly allocated to receive either pregabalin or placebo plus their current medication (sertraline). Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was used to evaluate the outcomes. Adverse effects were also registered.Results.Of the 56 patients with resistant OCD who were randomly allocated in 2 groups of pregabalin (n = 28) and placebo group (n = 28), 42 patients (22 in pregabalin group and 20 in placebo group) completed the trial. Throughout the trial, the mean score decreased from 26.13± 7.03 to 8.81 ± 3.47 in the pregabalin group (p < 0) and from 26.85 ± 4.34 to 17.63 ± 4.22 in the placebo group (p < 0). At the end of trial, 16 (57.14%) patients in the pregabalin group and 2 (7.14%) patients in the placebo group showed more than 35% decline in YBOCS (p < .01). The pregabalin group showed good tolerability and safety.Conclusions.Our study revealed that pregabalin, as an augmenting medication, is more effective than placebo in the treatment of patients with resistant OCD.

Gabapentin and pregabalin in bipolar disorder, anxiety states, and insomnia: Systematic review, meta-analysis, and rationale

“…Three DB-RCTs were included, two assessing adjunctive pregabalin for the treatment of PTSD [ 47 ] and OCD [ 48 ] and one assessing gabapentin for the treatment of PD [ 49 ] (also see Supplementary Appendix, Table 2 ). Quantitative synthesis was not conducted due to clinical and methodological heterogeneity.…”

Is mirtazapine augmentation effective for patients with obsessive-compulsive disorder who failed to respond to sertraline monotherapy? A placebo-controlled, double-blind, clinical trial

“…Several strategies have been used for the treatment of OCD patients who do not respond to SSRI medications. Augmenting the current regimen with another serotonergic enhancer is one strategy (Ravizza et al , 1996; Denys et al , 2004; Marazziti et al , 2008; Mowla et al , 2016). Adding antipsychotics or glutamatergic modulators to the SSRIs are other tactics used to approach these patients (Komossa et al , 2010; Matsunaga et al , 2011; Fineberg et al , 2015; Kishi et al , 2018; Talaei et al , 2020).…”

“…There is no standard cutoff point for YBOCS. A decline of at least 35% in YBOCS score was considered as response rate in this trial according to the results of similar prior studies (Sahraian et al , 2018; Mowla and Ghaedsharaf, 2020; Sahraian et al , 2021). The study psychiatrist assessed the adverse effects at each visit and recorded them.…”

Investigational and Experimental Drugs to Treat Obsessive-Compulsive Disorder

“…Pregabalin, a gamma-aminobutyric acid analog, modulates calcium channels and has been approved for its use in epilepsy, neuropathic pain, fibromyalgia, and generalized anxiety disorder. Anecdotal reports showed some efficacy of pregabalin for OCD and a recent placebocontrolled randomized trial showed positive results respect to placebo in a dose range between 75 and 225 mg. 127 A randomized controlled trial at the McMaster University in Canada investigated the effects of pregabalin in a flexible dose up to 600 mg for 8 weeks as an addition to SRIs treatment in resistant OCD. According to clinicaltrils.gov (last update mid-September 2020), the trial has concluded, but results are still not provided and, to the best of our knowledge, there are not available publications yet.…”