N-acetylcysteine Augmentation in Serotonin Reuptake Inhibitor Refractory Obsessive-compulsive Disorder

Overview

Journal Psychopharmacology (Berl)

Specialty Pharmacology

Date 2005 Dec 24

PMID 16374600

Citations 62

Authors

Daniel L Lafleur

Christopher Pittenger

Ben Kelmendi

Tom Gardner

Suzanne Wasylink

Robert T Malison

Gerard Sanacora

John H Krystal

Vladimir Coric

Affiliations

Soon will be listed here.

Abstract

Rationale: Dysfunction of glutamatergic neurotransmission has been implicated in the pathophysiology of obsessive-compulsive disorder (OCD) and recent clinical reports suggest that some glutamate modulating agents are efficacious in the treatment of this disorder. N-acetylcysteine (NAC) is a readily available amino acid compound that is thought to attenuate glutamatergic neurotransmission. NAC may be useful in treating psychiatric disorders involving glutamatergic dysfunction such as OCD.

Objectives: To examine the efficacy of augmentation with NAC in a patient with serotonin reuptake inhibitor (SRI)-refractory OCD.

Methods: A patient with SRI-refractory OCD was treated with an off-label use of NAC augmentation of fluvoxamine over several weeks.

Results: NAC augmentation of fluvoxamine resulted in a marked decrease in Yale-Brown Obsessive Compulsive Scale (Y-BBOCS) score and a clinically significant improvement in OCD symptoms.

Conclusions: NAC augmentation was effective in treating SRI-refractory OCD in this single case. Further research is warranted to investigate the use of NAC and other glutamate modulating agents in the treatment of OCD.

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