What is the role of glutamatergic agents in the treatment of obsessive-compulsive disorder (OCD)?

Updated: May 17, 2018
  • Author: William M Greenberg, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

Preclinical studies and several case reports and small clinical trials have provided some preliminary support for the therapeutic use of specific glutamatergic agents. [6, 7] However, these agents (eg, memantine, N -acetylcysteine, riluzole, topiramate, glycine) have varied glutamatergic and other pharmacologic effects, so if they are demonstrated to be effective, clarifying any therapeutic mechanism of action will be important.

The first double-blind, placebo-controlled trial conducted by Berlin et al suggests topiramate augmentation for treatment-resistant OCD may be beneficial for compulsions but not obsessions. [33] The modification of glutamatergic function may be partly responsible for the improved response in compulsions seen with topiramate.


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