Memantine Augmentation in Treatment-Resistant Adults With Obsessive-Compulsive Disorder
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 6/22/2017 |
| Start Date: | August 2009 |
| End Date: | December 2015 |
Open -Label Trial on the Effects of Memantine in Adults With Obsessive-Compulsive Disorder After a Single Ketamine Infusion
Obsessive-compulsive disorder (OCD) is a common psychiatric illness that affects up to 2-3%
of the population. People with OCD experience anxiety-provoking, intrusive thoughts, known
as obsessions, and feel compelled to perform repetitive behaviors, or compulsions. The only
medications proven effective for OCD are serotonin reuptake inhibitors (SRIs), but even with
SRI treatment, most patients continue to experience significant OCD symptoms, impaired
functioning, and diminished quality of life. Recent evidence suggest that a different
neurotransmitter, glutamate, may contribute to the symptoms in OCD. Medications that target
glutamate hold promise for ameliorating symptoms for those patients continuing to suffer
from OCD. In this study the investigators are recruiting patients to receive the drug
memantine, which is thought to modulate the neurotransmitter glutamate, added to whatever
other OCD medications they are taking.
Open label memantine will be titrated in 5mg increments weekly to target dose of 10mg po bid
for up to 6 weeks. Memantine will be continued to 12 weeks in those with treatment
response,13 either previous response to ketamine (≥ 35% Y-BOCS reduction 1 week after IV
ketamine) or current response to memantine (≥ 35% Y-BOCS reduction from pre- to post-6 weeks
of memantine).
of the population. People with OCD experience anxiety-provoking, intrusive thoughts, known
as obsessions, and feel compelled to perform repetitive behaviors, or compulsions. The only
medications proven effective for OCD are serotonin reuptake inhibitors (SRIs), but even with
SRI treatment, most patients continue to experience significant OCD symptoms, impaired
functioning, and diminished quality of life. Recent evidence suggest that a different
neurotransmitter, glutamate, may contribute to the symptoms in OCD. Medications that target
glutamate hold promise for ameliorating symptoms for those patients continuing to suffer
from OCD. In this study the investigators are recruiting patients to receive the drug
memantine, which is thought to modulate the neurotransmitter glutamate, added to whatever
other OCD medications they are taking.
Open label memantine will be titrated in 5mg increments weekly to target dose of 10mg po bid
for up to 6 weeks. Memantine will be continued to 12 weeks in those with treatment
response,13 either previous response to ketamine (≥ 35% Y-BOCS reduction 1 week after IV
ketamine) or current response to memantine (≥ 35% Y-BOCS reduction from pre- to post-6 weeks
of memantine).
see above
Inclusion Criteria:
1. Age 18-65 years old
2. Primary Diagnosis of OCD
3. Physically healthy and females must be using effective contraception
4. At lease moderate OCD symptoms (Yale-Brown Obsessive-Compulsive Scale [YBOCS]score
greater or equal to 16 prior to entering trial)
5. Able to provide consent
6. May be on or off selective reuptake inhibitor (SRI) medications
1. Patients on an SRI medication will be included if the dose is stable and
adequate (or if they don't want to increase their dose [e.g. side effects] and
have a history of prior SRI or CBT treatment meeting criteria for adequate
trial)
2. Patients not on an SRI medication will be included if they they have failed at
least 1 prior trial of standard OCD treatment (e.g. SRIs or CBT)
Exclusion Criteria:
1. Ongoing treatment with memantine
2. Patients planning to start CBT during the study period or those who have started CBT
within 8 weeks prior to study enrollment
3. Presence of psychotic symptoms or lifetime history of schizophrenia, bipolar
disorder, or other psychotic disorder.
4. Current major depressive disorder (patients must be free of the disorder for three
months prior to enrollment). Patients will be excluded if they are moderately to
severely depressed, but if they are mildly to moderately depressed they will be
included (Hamilton Depression Rating Scale must be <18).
5. Judged clinically to be at risk of suicide (suicidal ideation, severe depression, or
other factors).
6. Current eating disorder
7. Females who are pregnant or nursing
8. Severe renal insufficiency, severe hepatic impairment, or seizure disorder.
9. Documented history of hypersensitivity or intolerance to memantine.
10. Concomitant use of trimethoprim, N-methyl-D-aspartate receptor medications
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New York State Psychiatric Institute The New York State Psychiatric Institute (NYSPI), established in 1895,...
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