Glutamate-modulating drugs as novel pharmacotherapeutic agents in the treatment of obsessive-compulsive disorder

被引:132
作者
Pittenger C. [1 ]
Krystal J.H. [1 ]
Coric V. [1 ,2 ]
机构
[1] Yale University Department of Psychiatry, New Haven
[2] Yale University Department of Psychiatry, New Haven, CT 06508
来源
NeuroRX | 2006年 / 3卷 / 1期
基金
美国国家卫生研究院;
关键词
ALS; Glutamate; Magnetic resonance spectroscopy; Obsessive-compulsive disorder; Riluzole; Treatment-resistant;
D O I
10.1016/j.nurx.2005.12.006
中图分类号
学科分类号
摘要
Obsessive-compulsive disorder (OCD) is a common psychiatric disorder that produces significant morbidity. The introduction of serotonin reuptake inhibitors in the 1980s represented an important advance in the treatment of OCD. However, few patients show complete remission of their symptoms, and some patients show minimal improvement with existing treatments. We review current treatment strategies and initial data supporting the efficacy of glutamate modulating agents as a novel class of pharmaceuticals for the treatment of OCD. Functional neuroimaging studies repeatedly reported metabolic hyperactivity in the cortico-striato-thalamo-cortical circuitry in patients with OCD. Recent magnetic resonance spectroscopy studies provide evidence of elevated glutamate levels in several brain regions in patients suffering from OCD. These findings raised the possibility that agents that reduce glutamate hyperactivity or its consequences in the CNS might be efficacious as novel therapeutic interventions. Indeed, initial evidence from our group suggests that the antiglutamatergic agent riluzole (Rilutek), which was developed for the treatment of amyotrophic lateral sclerosis, is effective in treatment-resistant OCD. Case reports suggest that other agents that modulate glutamatergic activity may likewise be effective. This new application of glutamate modulating agents holds promise for the treatment of this disabling and often inadequately treated disease. © The American Society for Experimental NeuroTherapeutics, Inc.
引用
收藏
页码:69 / 81
页数:12
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