Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis

Abstract Background Obsessive-compulsive disorder (OCD) is among the most disabling neuropsychiatric conditions characterized by the presence of repetitive intrusive thoughts, impulses, or images (obsessions) and/or ritualized mental or physical acts (compulsions). Serotonergic medications, particul...

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Autores principales:	Fatemeh Hadi, Shayan Kashefinejad, Leila Kamalzadeh, Saba Hoobehfekr, Mohammadreza Shalbafan
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Glutamate Riluzole Memantine Minocycline Obsessive-compulsive disorder Systematic review Therapeutics. Pharmacology RM1-950 Toxicology. Poisons RA1190-1270
Acceso en línea:	https://doaj.org/article/5d4be219e9d64309804d7a0d2d597db3
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spelling	oai:doaj.org-article:5d4be219e9d64309804d7a0d2d597db32021-11-08T10:45:47ZGlutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis10.1186/s40360-021-00534-62050-6511https://doaj.org/article/5d4be219e9d64309804d7a0d2d597db32021-11-01T00:00:00Zhttps://doi.org/10.1186/s40360-021-00534-6https://doaj.org/toc/2050-6511Abstract Background Obsessive-compulsive disorder (OCD) is among the most disabling neuropsychiatric conditions characterized by the presence of repetitive intrusive thoughts, impulses, or images (obsessions) and/or ritualized mental or physical acts (compulsions). Serotonergic medications, particularly Selective Serotonin Reuptake Inhibitors (SSRIs), are the first-line treatments for patients with OCD. Recently, dysregulation of glutamatergic system has been proposed to be involved in the etiology of OCD. We designed this systematic review and meta-analysis to evaluate clinical efficacy of glutamatergic medications in patients with OCD, according to the guidelines of Cochrane collaboration. Method We searched Medline, Scopus, and Cochrane library without applying any language filter. Two of the authors independently reviewed search results for irrelevant and duplicate studies and extracted data and assessed methodological quality of the studies. We transformed data into a common rubric and calculated a weighted treatment effect across studies using Review Manager. Results We found 476 references in 3 databases, and after exclusion of irrelevant and duplicate studies, 17 studies with total number of 759 patients with OCD were included. In the present review we found evidence for several drugs such as memantine, N-acetylcysteine (NAC), Minocycline, L-carnosine and riluzole. Glutamaterigic drug plus SSRIs were superior to SSRI+ Placebo with regard to Y-BOCS scale [standardized mean difference (SMD = − 3.81 95% CI = − 4.4, − 3.23). Conclusion Augmentation of glutamatergic medications with SSRIs are beneficial in obsessive-compulsive patients, no harmful significant differences in any safety outcome were found between the groups.Fatemeh HadiShayan KashefinejadLeila KamalzadehSaba HoobehfekrMohammadreza ShalbafanBMCarticleGlutamateRiluzoleMemantineMinocyclineObsessive-compulsive disorderSystematic reviewTherapeutics. PharmacologyRM1-950Toxicology. PoisonsRA1190-1270ENBMC Pharmacology and Toxicology, Vol 22, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Glutamate Riluzole Memantine Minocycline Obsessive-compulsive disorder Systematic review Therapeutics. Pharmacology RM1-950 Toxicology. Poisons RA1190-1270
spellingShingle	Glutamate Riluzole Memantine Minocycline Obsessive-compulsive disorder Systematic review Therapeutics. Pharmacology RM1-950 Toxicology. Poisons RA1190-1270 Fatemeh Hadi Shayan Kashefinejad Leila Kamalzadeh Saba Hoobehfekr Mohammadreza Shalbafan Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis
description	Abstract Background Obsessive-compulsive disorder (OCD) is among the most disabling neuropsychiatric conditions characterized by the presence of repetitive intrusive thoughts, impulses, or images (obsessions) and/or ritualized mental or physical acts (compulsions). Serotonergic medications, particularly Selective Serotonin Reuptake Inhibitors (SSRIs), are the first-line treatments for patients with OCD. Recently, dysregulation of glutamatergic system has been proposed to be involved in the etiology of OCD. We designed this systematic review and meta-analysis to evaluate clinical efficacy of glutamatergic medications in patients with OCD, according to the guidelines of Cochrane collaboration. Method We searched Medline, Scopus, and Cochrane library without applying any language filter. Two of the authors independently reviewed search results for irrelevant and duplicate studies and extracted data and assessed methodological quality of the studies. We transformed data into a common rubric and calculated a weighted treatment effect across studies using Review Manager. Results We found 476 references in 3 databases, and after exclusion of irrelevant and duplicate studies, 17 studies with total number of 759 patients with OCD were included. In the present review we found evidence for several drugs such as memantine, N-acetylcysteine (NAC), Minocycline, L-carnosine and riluzole. Glutamaterigic drug plus SSRIs were superior to SSRI+ Placebo with regard to Y-BOCS scale [standardized mean difference (SMD = − 3.81 95% CI = − 4.4, − 3.23). Conclusion Augmentation of glutamatergic medications with SSRIs are beneficial in obsessive-compulsive patients, no harmful significant differences in any safety outcome were found between the groups.
format	article
author	Fatemeh Hadi Shayan Kashefinejad Leila Kamalzadeh Saba Hoobehfekr Mohammadreza Shalbafan
author_facet	Fatemeh Hadi Shayan Kashefinejad Leila Kamalzadeh Saba Hoobehfekr Mohammadreza Shalbafan
author_sort	Fatemeh Hadi
title	Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis
title_short	Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis
title_full	Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis
title_fullStr	Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis
title_full_unstemmed	Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis
title_sort	glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/5d4be219e9d64309804d7a0d2d597db3
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Glutamatergic medications as adjunctive therapy for moderate to severe obsessive-compulsive disorder in adults: a systematic review and meta-analysis

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