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Cited by 62Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesTreatment of Major Depression

Glutamatergic agents for OCD and related disorders

Open access
Pittenger, Christopher·2015·Current Treatment Options in Psychiatry
DOI 10.1007/s40501-015-0051-8PMC PMC4540409
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Abstract

Pharmacotherapy remains inadequate for many patients with OCD; there is an urgent need for alternative pharmacological strategies. Convergent evidence suggests imbalance in glutamate, the brain's primary excitatory neurotransmitter, in some patients. This has motivated interest in glutamate modulators in patients who are unresponsive to standard pharmacotherapeutic approaches. While no glutamate modulator can be considered proven as an efficacious treatment of OCD, promising suggestions of benefit have been reported for memantine and riluzole. The evidence is thinner for N-acetylcysteine, but this agent's low cost and benign side effect profile make it a reasonable consideration in certain patients. Intriguing research on D-cycloserine and ketamine suggest potential benefit as well. It is notable that these agents all work by different, and in some cases opposite, mechanisms; this suggests that we have much to learn about the role of glutamate dysregulation in the etiology of OCD, and of glutamate modulators in its treatment.

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Authors
Pittenger, C.
Affiliations
Yale University (US)
Corresponding author
Pittenger, Christopher
ORCID
Pittenger, Christopher
Venue
Current Treatment Options in Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2015-07-03
Volume
2
Issue
3
Pages
271-283
ISSN
2196-3061 (ISSN-L)
DOI
10.1007/s40501-015-0051-8
PMC
PMC4540409
OpenAlex
W810787593
Cited by
62
References
77
Citations by year
2026: 3 · 2025: 1 · 2024: 7 · 2023: 7 · 2022: 3 · 2021: 11 · 2020: 4 · 2019: 9 · 2018: 8 · 2017: 6 · 2016: 3
FWCI
7.04
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Current Treatment Options in Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R34MH083115, K08MH081190)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
obsessive-compulsive disorder, glutamate, glutamate modulators, memantine, riluzole, N-acetylcysteine, D-cycloserine, ketamine, pharmacotherapy, glutamate dysregulation, treatment-resistant OCD

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