Amantadine Augmentation Therapy for Obsessive Compulsive Patients Resistant to SSRIs—An Open-Label Study

Abstract

AMN adjunction to SSRI treatment may lead to a significant reduction in OC symptoms, supporting the hypothesis that transduction of the glutamate signal via NMDA receptor may play a role in OCD. A large scale, double-blind, placebo-controlled study is warranted to confirm our results.

Memantine Augmentation Improves Symptoms in Serotonin Reuptake Inhibitor-Refractory Obsessive-Compulsive Disorder: A Randomized Controlled Trial

“…The Y-BOCS is rated by clinicians and has proven validity and reliability for measuring OCD symptoms [32,33]. OCD severity is defined using Y-BOCS total score as extreme (score 32-40), severe (score 24-31), moderate (16)(17)(18)(19)(20)(21)(22)(23), and mild (8)(9)(10)(11)(12)(13)(14)(15) [33]. In the present study, the Y-BOCS was used to quantify the severity of OCD and evaluate treatment response, defined as ≥ 35 % reduction in Y-BOCS total score [34].…”

“…glutamate levels in cerebrospinal fluid, glutamatergic over-activity, and polymorphism of gene coding N-methyl-D-aspartate (NMDA) receptor are shown to contribute to OCD occurrence [11][12][13][14]. In addition, there is a large body of evidence on the clinical benefits of augmentation therapy with glutamate-modulating agents such as riluzole, N-acetylcysteine, ketamine, and amantadine in reducing symptoms in SRI-refractory OCD [15][16][17][18][19].…”

Amantadine as adjuvant therapy in the treatment of moderate to severe obsessive–compulsive disorder: A double‐blind randomized trial with placebo control

“…reported that a treatment‐resistant patient with OCD responded to amantadine (200 mg/day) added to clomipramine (225 mg/day) . In an open‐label study of amantadine in eight OCD patients who had failed one SSRI trial, significant reductions in total Y‐BOCS (28 ± 4.5 vs 18.8 ± 8.8; P < 0.01; d.f. = 7; t = 2.36), Y‐BOCS Compulsion subscale (15.3 ± 3.2 vs 10.6 ± 4.7; P < 0.02; d.f.…”

“…58 Pasquini et al reported that a treatment-resistant patient with OCD responded to amantadine (200 mg/day) added to clomipramine (225 mg/day). 59 In an open-label study of amantadine in eight OCD patients who had failed one SSRI trial, 28 This study has some limitations that need to be addressed as they may impair interpretation of the findings. First, due to ethical considerations, there was no placebo-only group in this study.…”

“…Amantadine, an uncompetitive antagonist of the NMDA‐type glutamate receptor, has previously been used to treat Alzheimer's and Parkinson's disease, and influenza infection . To the best of our knowledge, only one open‐label study has been conducted, in 2014, investigating the effects of amantadine in patients with OCD . Given this evidence, we conducted this double‐blind placebo‐controlled trial to assess the efficacy and safety of amantadine as an augmentative agent to fluvoxamine in the treatment of moderate to severe OCD.…”