title: Obsessive compulsive disorder and the glutamatergic system.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: aEastern Health, Maroondah Hospital Adult Mental Health Services, Melbourne, Victoria, Australia bNovartis Institutes for Biomedical Research, Translational Medicine Neuroscience, Basel, Switzerland cDepartment of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa.
authors.forename: Catherine
authors.initials: C
authors.lastname: Kariuki-Nyuthe
authors.forename: Baltazar
authors.initials: B
authors.lastname: Gomez-Mancilla
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D018683:Excitatory Amino Acid Agents / Q000627:therapeutic use*; D006801:Humans; D059906:Neuroimaging / Q000379:methods; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D018683:Excitatory Amino Acid Agents; D017367:Selective Serotonin Reuptake Inhibitors