Predicting Medication Response in Obsessive Compulsive Disorder
Status:
Completed
Trial end date:
2011-12-01
Target enrollment:
Participant gender:
Summary
In this study, the investigators hope to study a number of variables the investigators
believe may help us predict why some people respond better to some medications than others.
Participants will be randomly assigned to receive one of two typical medications for OCD,
clomipramine or escitalopram. Individuals who would like to participate but who have
previously tried one or both of these medications may instead take a newer drug, duloxetine,
and undergo the identical procedures. The factors the investigators will be studying include
demographics (i.e. age, gender, age of onset of OCD), genetic markers (such as variants in
genes involved in breaking down drugs in the liver (cytochrome P450 system), and genes
involved in several brain chemical systems, such as serotonin), the dimensions of OCD
symptoms (i.e. checking, washing, and hoarding) and cortical inhibition. Cortical inhibition
will be measured transcranial magnetic stimulation and is being studied because deficits in
this process may be important in the development of OCD. The investigators hypothesize that
certain pretreatment clinical characteristics will correlate with poor treatment response
including earlier age of onset, longer duration of illness, increased YBOCS severity and
presence of significant hoarding symptoms. The investigators expect that increasing degree of
deficit in CI pre-treatment will predict poor treatment response, but that increase in CI
from pre- to post-treatment will correlate with a positive treatment response. Differences in
genetic marker status for cytochrome P450 genes will correlate with tolerability and/or
response, as well as differences in genetic marker status in SLC1A1, GRIN2B, 5HT1B and 5HT2A
will correlate with response.
Phase:
N/A
Details
Lead Sponsor:
Sunnybrook Health Sciences Centre
Collaborators:
Centre for Addiction and Mental Health Obsessive Compulsive Foundation