Glutamatergic meds beneficial in obsessive-compulsive disorder

Glutamatergic medications appear to be efficacious in the treatment of individuals with obsessive-compulsive disorder (OCD), according to the results of a meta-analysis.

Researchers searched multiple online databases for double-blind randomized controlled trials in which glutamatergic medications were compared with placebo in the treatment of patients with obsessive-compulsive and related disorders (OCRDs) regardless of age, sex, gender, or refractoriness.

Twenty-seven trials met the inclusion criteria and were included, with the total population comprising 1,369 participants (mean age 31.5 years, 65.6 percent female). Random-effects meta-analyses were used, with subgroup analyses performed according to type of OCRD, population, refractoriness of OCRD, augmentation strategy, risk of bias, and type of glutamatergic medication.

Pooled data showed that glutamatergic medications had a large effect size in terms of improving OCRD symptoms (Cohen d, −0.80, 95 percent confidence interval [CI], −1.13 to −0.47; low certainty of evidence). In the 23 OCD-specific trials, glutamatergic medications yielded significant reductions in mean Yale-Brown Obsessive Compulsive Scale scores (mean difference, −4.17, 95 percent CI, −5.82 to −2.52; moderate certainty of evidence).

In subgroup analyses, the results did not differ by type of OCRD, population, refractoriness of OCRD or OCD, augmentation strategy, risk of bias, or type of glutamatergic medication. 

The researchers called for more studies with larger sample sizes and that focus on dose-dependent effects, additional OCRD subtypes, and novel glutamatergic treatments.