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The increasing evidence for the involvement of the glutamatergic system in the pathophysiology of obsessive-compulsive disorder (OCD) has led to trials of agents such as N-acetylcysteine, riluzole, and d-cycloserine. Augmentation with memantine, an N-methyl-d-aspartate receptor antagonist, has shown initial promise in case reports and open-label trials. In this randomized, double-blind, placebo-controlled Iranian trial, researchers examined the effect of adding memantine to fluvoxamine in 38 outpatients with moderate-to-severe OCD (26 women; age range, 18–60). Participants had no substance dependence, other axis I disorders, or serious medical illness.
The study regimen was 8 weeks of fluvoxamine (100 mg/day for 4 weeks, then 200 mg/day) plu…