Glutamate-Modulating Drugs as a Potential Therapeutic Strategy in Obsessive-Compulsive Disorder
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OBJECTIVE: Obsessive-compulsive disorder (OCD) is a mental disease commonly associated with severe distress and impairment of social functioning. Serotonin reuptake inhibitors and/or cognitive behavioural therapy are the therapy of choice, however up to 40% of patients do not respond to treatment. Glutamatergic signalling has also been implicated in OCD. The aim of the current study was to review the clinical evidence for therapeutic utility of glutamate-modulating drugs as an augmentation or monotherapy in OCD patients. METHODS: We conducted a search of the MEDLINE database for clinical studies evaluating the effect of glutamate-modulating drugs in OCD. RESULTS: Memantine is the compound most consistently showing a positive effect as an augmentation therapy in OCD. Anti-convulsant drugs (lamotrigine, topiramate) and riluzole may also provide therapeutic benefit to some OCD patients. Finally, ketamine may be of interest due to its potential for a rapid onset of action. CONCLUSION: Further randomized placebo-controlled trials in larger study populations are necessary in order to draw definitive conclusions on the utility of glutamate-modulating drugs in OCD. Furthermore, genetic and epigenetic factors, clinical symptoms and subtypes predicting treatment response to glutamate-modulating drugs need to be investigated systematically.
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Glutamate is the main excitatory neurotransmitter within CSTC loops.
“glutamate, the main excitatory neurotransmitter within CSTC loops”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Marinova et al., 2017
Research on glutamatergic agents for treatment-resistant OCD is still preliminary despite promising findings.
“Notwithstanding promising findings (e.g., for glutamate modulators like memantine and n‐acetyl cysteine), this research is still preliminary”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Marinova et al., 2017
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- Authors
- Marinova, Z., Chuang, D.-M., & Fineberg, N.
- Affiliations
- Klinik Barmelweid (CH)
- National Institutes of Health (US)
- University of Hertfordshire (GB)
- Corresponding author
- Marinova, Zoya
- ORCID
- Fineberg, Naomi
- Venue
- Current Neuropharmacology
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2017-08-28
- Volume
- 15
- Issue
- 7
- Pages
- 977-995
- ISSN
- 1570-159X (ISSN-L)
- PMC
- PMC5652017
- OpenAlex
- W2752397193
- Cited by
- 83
- References
- 154
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 11 · 2021: 18 · 2020: 3 · 2019: 8 · 2018: 11 · 2017: 1
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Current Neuropharmacology (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, glutamatergic signalling, memantine, lamotrigine, topiramate, riluzole, ketamine, augmentation therapy, treatment-resistant OCD, antiepileptic drugs
- MeSH terms
- Clinical Trials as Topic, Humans, Obsessive-Compulsive Disorder, Psychotropic Drugs, Excitatory Amino Acid Agents
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