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Current pharmaceutical treatments for obsessive-compulsive disorder (OCD) are limited to serotonergic antidepressants and augmentation with atypical antipsychotics. In a meta-analysis of eight randomized, placebo-controlled trials, researchers examined the efficacy of augmentation with a broad group of agents affecting the glutamate system (glycine, N-acetylcysteine, lamotrigine, topiramate, and memantine) in OCD patients already taking antidepressants.
Six trials enrolled patients with treatment-resistant OCD (symptom reduction, <25%). With response defined as ≥35% reduction in symptoms, the relative risk ratio for response with add-on glutamatergic medications was 3.7 overall and 4.3 for refractory OCD. The authors found evidence of public…