Combined fluvoxamine and extended-release methylphenidate improved treatment response compared to fluvoxamine alone in patients with treatment-refractory obsessive-compulsive disorder: A randomized double-blind, placebo-controlled study

• Published in: European neuropsychopharmacology 2019-03, Vol.29 (3), p.397-404
• Main Authors: Zheng, Huirong, Jia, Fujun, Han, Hongying, Wang, Shibin, Guo, Guangquan, Quan, Dongming, Li, Gang, Huang, Huiyan
• Format: Article
• Language: English
• Subjects: Adult; Augmentation; Dopamine Uptake Inhibitors - therapeutic use; Double-Blind Method; Drug Therapy, Combination; Female; Fluvoxamine - therapeutic use; Humans; Male; Methylphenidate (MPH) of extended-release formulations (MPH-ER); Methylphenidate - therapeutic use; Obsessive-Compulsive Disorder - drug therapy; Psychiatric Status Rating Scales; Retrospective Studies; Serotonin Uptake Inhibitors - therapeutic use; Treatment Outcome; Treatment-refractory obsessive-compulsive disorder; Young Adult
• ISSN: 0924-977X; 1873-7862
• DOI: 10.1016/j.euroneuro.2018.12.010

More effective, tolerable interventions for treatment-refractory obsessive-compulsive disorder (OCD) are needed. Preliminary findings encourage optimism that methylphenidate augmentation may be of benefit in the treatment of OCD. To test modulator methylphenidate (MPH) of extended-release formulations (MPH-ER) a safe and effective add-on therapy for refractory OCD, a pilot randomized, placebo-controlled, double-blind trial was conducted at an outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor (SRI) treatment-refractory OCD and receiving a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. Data were analyzed in the intention-to-treat sample. All subjects were randomized into two parallel groups to receive fluvoxamine (250 mg daily) plus MPH-ER (36 mg daily) or fluvoxamine (250 mg daily) plus identical placebo tablets under double-blind conditions and followed for 8 weeks. Forty-four patients (29 [66%] men), with a mean (SD) age of 24.7 (6) years participated; with a mean (SD) duration of episode 5.7 (3) were randomized and forty-one finished the trial. In the intention-to-treat analysis, the improvement in the Y-BOCS total score and Y-BOCS obsession subscale score was more prominent in the fluvoxamine and MPH-ER group compared with those receiving placebo (P