N-Acetylcysteine Augmentation in Treatment-Refractory Obsessive-Compulsive Disorder
Status:
Terminated
Trial end date:
2011-04-01
Target enrollment:
Participant gender:
Summary
Obsessive-compulsive disorder (OCD) affects 2-3% of the population and leads to a great deal
of suffering. Many patients benefit from established treatments, the mainstay of which are
cognitive behavioral therapy and a group of antidepressant medications known as serotonin
reuptake inhibitors. However, 20-30% of patients get minimal benefit from these established
therapeutic strategies. New avenues of treatment are urgently needed.
Existing medications for obsessive-compulsive disorder affect the neurotransmitters serotonin
or dopamine; but increasing evidence suggests that functional disruptions of a different
neurotransmitter, glutamate, may contribute to some cases of OCD. The researchers are
therefore interested in using medications that target glutamate as novel treatment options
for those OCD patients who do not benefit from established treatments.
One such medication is the drug N-Acetylcysteine, whose glutamatergic antagonistic properties
may be effective in reducing the glutamatergic hyperactivity that is thought to contribute to
the pathophysiology of OCD and major depressive disorder (MDD).
Riluzole, which is FDA approved for amyotrophic lateral sclerosis (ALS, or Lou Gehrig's
disease) is also a glutamatergic agent. There is evidence that riluzole possesses
anti-depressant, anti-obsessional, and anti-anxiety properties.
The modulation of glutamatergic activity is a promising new approach to the treatment of mood
disorders. The researchers are therefore now recruiting patients to participate in a
double-blind, placebo-controlled trial of N-Acetylcysteine, added to whatever other OCD
medications they are taking.