Sequential administration of augmentation strategies in treatment-resistant obsessive-compulsive disorder: preliminary findings.
Given that an important proportion of patients with obsessive-compulsive disorder (OCD) fail to respond adequately to serotonin (5-HT) reuptake inhibitors (SRI), augmentation strategies aimed at enhancing further 5-HT transmission by different mechanisms were attempted sequentially in 13 SRI-resistant patients. Addition of the 5-HT1A l beta-adrenergic antagonist pindolol did not alter OCD symptomatology but produced a rapid improvement of depressive symptoms. The 5-HT1A agonist buspirone as well as 5-hydroxytryptophan, the immediate precursor of 5-HT, added to the SRI-pindolol regimen, were not effective in attenuating the intensity of OCD. Tryptophan, added to the SRI-pindolol regimen, produced a significant improvement after 4 weeks, with further amelioration after 6 weeks (36% decrease of the Yale-Brown Obsessive Compulsive Score), which was maintained with treatment prolongation.
Blier
P
P
Neurobiological Psychiatry Unit, McGill University, Montréal, Québec, Canada.
Bergeron
R
R
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000328:Adult; D002065:Buspirone / Q000494:pharmacology; D003863:Depression / Q000188:drug therapy; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D010869:Pindolol / Q000494:pharmacology*; D017366:Serotonin Receptor Agonists / Q000494:pharmacology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014364:Tryptophan / Q000494:pharmacology
D000319:Adrenergic beta-Antagonists; D002065:Buspirone; D010869:Pindolol; D017366:Serotonin Receptor Agonists; D017367:Selective Serotonin Reuptake Inhibitors; D014364:Tryptophan