An open-label trial of riluzole, a glutamate antagonist, in children with treatment-resistant obsessive-compulsive disorder.
BACKGROUND
Obsessive-compulsive disorder (OCD) in childhood is often refractory to treatment. Riluzole, a glutamate antagonist, has theoretical support as an alternative pharmacological treatment and has demonstrated possible benefit in some open-label trials in adults with OCD.


METHODS
Six subjects, ages 8-16 years, were enrolled in a 12-week open-label trial of riluzole for OCD symptoms that had resisted prior treatments. OCD symptoms and adverse effects of drug were monitored.


RESULTS
Four of 6 subjects had clear benefit, with reduction of more than 46% (39% overall) on Children's Yale-Brown Obsessive-Compulsive Scale, and "Much Improved" or "Very Much Improved" on the Clinical Global Impressions-Improvement scale. Two subjects had no clinically meaningful change in symptom severity by 12 weeks, but 1 subject improved thereafter. There were no adverse effects of drug sufficient to cause discontinuation or reduction of dose. All subjects elected to continue riluzole after the 12-week trial.


CONCLUSIONS
Riluzole may be beneficial for treatment-resistant OCD in young subjects and seems well tolerated. A placebo-controlled trial of the drug is planned.
Grant
Paul
P
Pediatrics and Developmental Neuropsychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA. paul.grant@nih.gov
Lougee
Lorraine
L
Hirschtritt
Matthew
M
Swedo
Susan E
SE
D000293:Adolescent; D002648:Child; D004351:Drug Resistance; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D011569:Psychiatric Status Rating Scales; D019782:Riluzole / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D018691:Excitatory Amino Acid Antagonists; D019782:Riluzole