Sarcosine therapy for obsessive compulsive disorder: a prospective, open-label study

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Glutamatergic neurotransmission is implicated in obsessive compulsive disorder (OCD) pathophysiology.
• Sarcosine, a glycine transporter-1 antagonist, may enhance N-methyl-d-aspartate (NMDA) receptor activity by increasing synaptic glycine.
• This study investigated sarcosine's therapeutic potential in OCD patients.

Purpose of the Study:

• To evaluate the efficacy and tolerability of sarcosine in treating obsessive compulsive disorder (OCD).
• To explore sarcosine's effects on symptom severity in both treatment-naive and previously treated OCD patients.

Main Methods:

• An open-label trial involving 26 outpatients with OCD (Yale-Brown Obsessive Compulsive Scale [YBOCS] > 16).
• Participants received flexible doses of sarcosine (500–2000 mg/d) as monotherapy or adjunctive treatment for 10 weeks.
• Symptom severity (YBOCS) and anxiety (Hamilton Anxiety Inventory) were assessed bi-weekly.

Main Results:

• Twenty-five subjects completed the study; mean YBOCS scores decreased by 19.8% (P = 0.0035).
• 32% of subjects were classified as responders ( > 35% YBOCS reduction), with some achieving early response by week 4.
• Treatment-naive subjects showed a trend towards more profound and sustained improvement compared to previously treated patients. Sarcosine was well-tolerated.

Conclusions:

• Sarcosine can rapidly improve symptoms in some OCD patients, especially those treatment-naive.
• The glycine transporter-1 represents a potential therapeutic target for novel OCD treatments.
• Further large-scale, placebo-controlled, double-blind studies are warranted to confirm these findings.