Agomelatine augmentation in obsessive compulsive disorder: a preliminary report.

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Obsessive-compulsive disorder (OCD) affects 2% of the population and is highly disabling.
• Current OCD treatments primarily target serotonin and dopamine systems, with limited efficacy in some patients.
• Treatment-resistant OCD necessitates novel therapeutic strategies, including augmentation treatments.

Purpose of the Study:

• To investigate the efficacy and safety of agomelatine as an augmentation treatment in patients with treatment-resistant OCD.
• To explore the potential benefits of agomelatine's dual action on melatoninergic and serotoninergic systems for refractory OCD.

Main Methods:

• An open-label study involving 12 adult patients with treatment-resistant OCD.
• Patients received agomelatine augmentation for 16 weeks after failing adequate Serotonin Reuptake Inhibitor treatment.
• Efficacy was assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS); safety was monitored for adverse events.

Main Results:

• Agomelatine augmentation resulted in a significant improvement in Y-BOCS scores (p<0.005) after 16 weeks.
• A 25% average improvement in Y-BOCS scores was observed in patients with refractory OCD.
• Agomelatine augmentation was well-tolerated, with mild side effects (nausea, headache, dizziness, somnolence) and no dropouts.

Conclusions:

• Agomelatine may be an efficacious and well-tolerated augmenting agent for treatment-resistant OCD.
• The dual action of agomelatine on serotoninergic and melatoninergic systems warrants further investigation in OCD treatment.
• Further controlled studies are needed to confirm agomelatine's efficacy and explore the role of circadian rhythm modulation in OCD.