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Current Opinion in Psychiatry:
doi: 10.1097/YCO.0000000000000017
MOOD AND ANXIETY DISORDERS: Edited by Cornelius Katona and Gordon Parker

Obsessive compulsive disorder and the glutamatergic system

Kariuki-Nyuthe, Catherinea; Gomez-Mancilla, Baltazarb; Stein, Dan J.c

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Abstract

Purpose of review: Evidence-based pharmacological interventions for obsessive compulsive disorder (OCD) are targeted mainly at the serotonergic and dopaminergic pathways, and are not always effective. It is timely to review the growing evidence from animal models and clinical research (e.g., brain imaging, genetics) on the role of the glutamatergic system in OCD.

Recent findings: Emerging evidence from both animal models and clinical research (including brain imaging, neurogenetics) supports the glutamatergic system as a potential target for pharmacotherapy in OCD. Although there have been relatively few randomized controlled trials of glutamatergic agents in pediatric or adult OCD to date, there is some work on riluzole, memantine, ketamine, topiramate, lamotrigine, N-acetylcysteine, and D-cycloserine.

Summary: Given the need for more efficacious treatments in OCD, and given emergent findings on the role of the glutamatergic system in this disorder, there is a need for additional pharmacotherapy trials on glutamatergic agents in OCD. Possible research designs for such trials might include stand-alone approaches, pharmacotherapy augmentation, or psychotherapy augmentation.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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