Document Detail


Topiramate augmentation in treatment-resistant obsessive-compulsive disorder: a retrospective, open-label case series.
MedLine Citation:
PMID:  16178009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Serotonin reuptake inhibitors (SRIs) are considered first-line treatments for obsessive-compulsive disorder (OCD). Many patients achieve some response but remain symptomatic despite an adequate SRI trial. Recent neuroimaging data found abnormally high glutamatergic concentrations in children with OCD. Following selective serotonin reuptake inhibitor (SSRI) treatment, a decrease in OCD symptom severity was associated with a decrease in caudate glutamatergic concentrations. We initiated an investigation of adjunctive topiramate (an anticonvulsant agent with glutamatergic properties) in the treatment of patients with OCD who were partially or nonresponsive to SRI treatment. Sixteen consecutive outpatients with OCD (mean age = 41.1 years; range = 21-58 years), who were partial or nonresponders to SRI monotherapy or SRI combination therapy (antipsychotic, other antidepressant, or benzodiazepines), and had topiramate added over a minimum of 14 weeks, were reviewed. Baseline and endpoint Clinical Global Impression-Severity (CGI-S) and CGI-Improvement (CGI-I) were evaluated retrospectively. Eleven of 16 patients were responders (68.8%) with a CGI-I score of much improved or very much improved. The mean dose of topiramate was 253.1 +/- 93.9 mg/day. The mean time to response was 9.2 +/- 4.5 weeks. CGI-S scores decreased significantly from initiation of topiramate until 26 weeks, from 6.1 +/- 0.9 to 4.5 +/- 1.3 (P < .001). This case series suggests some preliminary evidence that the addition of topiramate may be useful in treatment-resistant OCD.
Authors:
Michael Van Ameringen; Catherine Mancini; Beth Patterson; Mark Bennett
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Depression and anxiety     Volume:  23     ISSN:  1091-4269     ISO Abbreviation:  Depress Anxiety     Publication Date:  2006  
Date Detail:
Created Date:  2006-01-26     Completed Date:  2006-06-13     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  9708816     Medline TA:  Depress Anxiety     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-5     Citation Subset:  IM    
Copyright Information:
Copyright 2005 Wiley-Liss, Inc.
Affiliation:
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada. vanamer@mcmaster.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticonvulsants / pharmacology,  therapeutic use*
Antipsychotic Agents / metabolism,  therapeutic use
Anxiety Disorders / drug therapy,  epidemiology
Caudate Nucleus / drug effects,  metabolism
Drug Resistance*
Drug Synergism
Female
Fructose / analogs & derivatives*,  pharmacology,  therapeutic use
Glutamic Acid / metabolism
Humans
Male
Mental Disorders / drug therapy
Middle Aged
Obsessive-Compulsive Disorder / drug therapy*,  epidemiology
Retrospective Studies
Serotonin Uptake Inhibitors / metabolism,  therapeutic use
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Antipsychotic Agents; 0/Serotonin Uptake Inhibitors; 0H73WJJ391/topiramate; 30237-26-4/Fructose; 56-86-0/Glutamic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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