pregabalin and Obsessive-Compulsive-Disorder

Glutamate dysfunction has been shown to be associated with pathophysiology of obsessive-compulsive disorder (OCD). Our objective is to survey the effects of pregabalin (a glutamate-modulating agent) as an augmenting treatment for resistant OCD.. In this 12-week double-blind placebo-controlled clinical trial, 56 patients with resistant OCD were randomly allocated to receive either pregabalin or placebo plus their current medication (sertraline). Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to evaluate the outcomes. Adverse effects were also registered.. Of the 56 patients with resistant OCD who were randomly allocated in 2 groups of pregabalin (n = 28) and placebo group (n = 28), 42 patients (22 in pregabalin group and 20 in placebo group) completed the trial. Throughout the trial, the mean score decreased from 26.13± 7.03 to 8.81 ± 3.47 in the pregabalin group (p < 0) and from 26.85 ± 4.34 to 17.63 ± 4.22 in the placebo group (p < 0). At the end of trial, 16 (57.14%) patients in the pregabalin group and 2 (7.14%) patients in the placebo group showed more than 35% decline in YBOCS (p < .01). The pregabalin group showed good tolerability and safety.. Our study revealed that pregabalin, as an augmenting medication, is more effective than placebo in the treatment of patients with resistant OCD.

Topics: Adult; Anti-Anxiety Agents; Female; Humans; Male; Middle Aged; Obsessive-Compulsive Disorder; Pregabalin

The therapeutic limitations of mainstay psychopharmacological treatments of obsessive-compulsive disorder (OCD) warrant the clinical testing of further add-on agents to improve patients' clinical symptoms. One such agent might be pregabalin, which has been found efficacious in other anxiety disorders. We report on the findings of a small, 8-week open-label trial of adjunctive pregabalin with a 4-week follow-up in 10 OCD patients resistant or only partial responders to a combination of serotonin reuptake inhibitors with atypical antipsychotics. Adjunctive pregabalin at 225-675 mg/d was well tolerated and led to patients' substantial improvement in their OCD symptoms, as reflected in their scores on the Yale-Brown Obsessive Compulsive Scale. Despite the several limitations of the study, its results suggest that adjunctive pregabalin might be a safe and efficacious new augmentation agent in the treatment of drug-resistant OCD. We hypothesize that pregabalin's mechanism of action in OCD might consist in its inhibition of glutamatergic neurotransmission.

Topics: Adult; Anti-Anxiety Agents; Antipsychotic Agents; Drug Resistance; Drug Therapy, Combination; Female; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Obsessive-Compulsive Disorder; Pregabalin; Psychiatric Status Rating Scales; Selective Serotonin Reuptake Inhibitors; Treatment Outcome; Young Adult

Topics: Adult; Anticonvulsants; Drug Resistance; Drug Therapy, Combination; Female; gamma-Aminobutyric Acid; Humans; Male; Middle Aged; Obsessive-Compulsive Disorder; Pregabalin; Selective Serotonin Reuptake Inhibitors; Severity of Illness Index; Treatment Outcome

Pregabalin (PRE) acts as a presynaptic inhibitor of the release of excessive levels of excitatory neurotransmitters by selectively binding to the alpha(2)-delta subunit of voltage-gated calcium channels. In this randomised, double-blind comparison trial with naltrexone (NAL), we aimed to investigate the efficacy of PRE on alcohol drinking indices. Craving reduction and improvement of psychiatric symptoms were the secondary endpoints. Seventy-one alcohol-dependent subjects were detoxified and subsequently randomised into two groups, receiving 50 mg of NAL or 150-450 mg of PRE. Craving (VAS; OCDS), withdrawal (CIWA-Ar) and psychiatric symptoms (SCL-90-R) rating scales were applied. Alcohol drinking indices and craving scores were not significantly different between groups. Compared with NAL, PRE resulted in greater improvement of specific symptoms in the areas of anxiety, hostility and psychoticism, and survival function (duration of abstinence from alcohol). PRE also resulted in better outcome in patients reporting a comorbid psychiatric disorder. Results from this study globally place PRE within the same range of efficacy as that of NAL. The mechanism involved in the efficacy of PRE in relapse prevention could be less related to alcohol craving and more associated with the treatment of the comorbid psychiatric symptomatology.

Topics: Adult; Alcohol Withdrawal Delirium; Alcohol-Related Disorders; Anticonvulsants; Anxiety; Calcium Channel Blockers; Double-Blind Method; Female; gamma-Aminobutyric Acid; Hostility; Humans; Male; Middle Aged; Naltrexone; Narcotic Antagonists; Obsessive-Compulsive Disorder; Pregabalin; Severity of Illness Index; Substance Withdrawal Syndrome

Anxiety disorders are frequently under-diagnosed conditions in primary care, although they can be managed effectively by general practitioners.. This paper is a short and practical summary of the World Federation of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) for the treatment in primary care. The recommendations were developed by a task force of 30 international experts in the field and are based on randomized controlled studies.. First-line pharmacological treatments for these disorders are selective serotonin reuptake inhibitors (for all disorders), serotonin-norepinephrine reuptake inhibitors (for some) and pregabalin (for generalized anxiety disorder only). A combination of medication and cognitive behavior/exposure therapy was shown to be a clinically desired treatment strategy.. This short version of an evidence-based guideline may improve treatment of anxiety disorders, OCD, and PTSD in primary care.

Topics: Antidepressive Agents, Tricyclic; Antipsychotic Agents; Anxiety Disorders; Benzodiazepines; Dose-Response Relationship, Drug; gamma-Aminobutyric Acid; Histamine Antagonists; Humans; Obsessive-Compulsive Disorder; Pregabalin; Selective Serotonin Reuptake Inhibitors; Stress Disorders, Post-Traumatic

Usher syndrome, the most common case of deaf - blindness, may be associated with various psychiatric disorders. Inability of communication through spoken language in association with progressive visual impairment affects diagnostics and management in case of co-morbidity with mental disorder. A patient with Usher syndrome and psychiatric symptoms is described and the difficulties in psychiatric assessment in her case are discussed. A 28 years old woman with hearing impairment diagnosed at the age of 3 months and progressive pigmentary retinopathy diagnosed at the age of 19 years, has been treated for ADHD in childhood, eating disorder in adolescence and psychosis-like disorder in adult life. Direct observation of patient behavior and the effects of pharmacotherapy were the main diagnostic procedures, since the use of sign language and handwriting was very limited. The limitations of management are discussed.

Topics: Adult; Anorexia Nervosa; Anti-Anxiety Agents; Antipsychotic Agents; Clozapine; Comorbidity; Diagnosis, Differential; Drug Therapy, Combination; Female; gamma-Aminobutyric Acid; Humans; Mental Disorders; Obsessive-Compulsive Disorder; Pregabalin; Psychotic Disorders; Recurrence; Social Isolation; Usher Syndromes; Violence

Topics: Anticonvulsants; Benzodiazepines; Female; gamma-Aminobutyric Acid; Humans; Middle Aged; Obsessive-Compulsive Disorder; Pregabalin