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Double-blind study of dextroamphetamine versus caffeine augmentation for treatment-resistant obsessive-compulsive disorder

Koran LM, Aboujaoude E, Gamel NN

The Journal of clinical psychiatry · 49 citas

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Cómo se estudió

Diseño
Ensayo controlado aleatorizado (indexado por PubMed)
Estudiado en
Personas
Resultado principal
Marcadores de salud y funcionamiento

Quién lo pagó

Financiación
Financiación no declarada

Publicación

Publicado
2009-06-30 · J Clin Psychiatry · vol. 70 · número 11 · págs. 1530–1535
Editorial
Physicians Postgraduate Press, Inc.
Citado
79 citas · más que el 96% de estudios similares · 6.1× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
0 trabajos
Acceso
De pago
Áreas de investigación
Obsessive-Compulsive Spectrum Disorders · Schizophrenia research and treatment · Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Palabras clave
obsessive-compulsive disorder, d-amphetamine, treatment-resistant OCD, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, Yale-Brown Obsessive Compulsive Scale, adverse effects, treatment discontinuation
MeSH
humans, dextroamphetamine, caffeine, neurotransmitter uptake inhibitors, treatment outcome, drug therapy, combination, drug administration schedule, longitudinal studies, double-blind method, obsessive-compulsive disorder, psychiatric status rating scales, drug resistance, diagnostic and statistical manual of mental disorders, adult, middle aged, female, male, selective serotonin reuptake inhibitors

3 autores

  • Koran Lm🇺🇸Stanford University
  • Elias N. Aboujaoude
  • Nona N. Gamel

Resumen

El texto original del estudio, en el idioma en que se publicó.

Introduction

Two small, double-blind, placebo-controlled, single-dose, crossover studies found dextroamphetamine (d-amphetamine) 30 mg clearly superior to placebo in relieving symptoms of obsessive-compulsive disorder (OCD). We conducted a 5-week, double-blind, caffeine-controlled study to test the hypothesis that d-amphetamine, added after an adequate selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) trial, would be more effective than caffeine in reducing residual OCD symptoms of moderate or greater severity.

Method

Between August 2006 and February 2008, we enrolled adults with DSM-IV OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of >or= 20 after >or= 12 weeks of adequate treatment with an SSRI or SNRI. Subjects were randomly assigned to double-blind d-amphetamine 30 mg/d or caffeine 300 mg/d added to their SSRI/SNRI and other medications. Responders (first week mean Y-BOCS score decrease of >or= 20%) entered the study's 4-week double-blind extension phase.

Results

We enrolled 24 subjects, 11 women and 13 men, with a mean (SD) age of 40 (13.2) years and mean baseline Y-BOCS scores of 26.5 (4.1) for the d-amphetamine group (n = 12) and 29.1 (4.0) for the caffeine group (n = 12). At the end of week 1, 6 of 12 d-amphetamine subjects (50%) and 7 of 12 caffeine subjects (58%) were responders. At week 5, the responders' mean Y-BOCS score decreases were, for the d-amphetamine group (last observation carried forward), 48% (range, 20%-80%); and, for the caffeine group, 55% (range, 27%-89%). Obsessive-compulsive disorder and depression improvement were independent. The double-blind remained intact. No subject discontinued the study due to side effects.

Conclusions

Larger, double-blind, placebo-controlled trials of both d-amphetamine and caffeine augmentation are needed in OCD subjects inadequately responsive to adequate doses of an SSRI or SNRI.

Trial registration

clinicaltrials.gov Identifier: NCT00363298.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.

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