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Augmentation With Memantine in Obsessive-Compulsive Disorder.

Chittaranjan Andrade¹

¹Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, India. candrade@psychiatrist.com.

The Journal of Clinical Psychiatry

|December 18, 2019

Summary

This summary is machine-generated.

Memantine augmentation for obsessive-compulsive disorder (OCD) showed large benefits in a meta-analysis. However, concerns about study validity and generalizability mean memantine cannot yet be recommended for OCD treatment.

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Area of Science:

Psychiatry and Behavioral Sciences
Pharmacology and Therapeutics

Background:

Obsessive-compulsive disorder (OCD) often requires augmentation strategies when initial treatments fail.
Atypical antipsychotics are common SRI augmentation agents; memantine is an alternative being investigated.

Purpose of the Study:

To critically evaluate the findings of a recent systematic review and meta-analysis on memantine augmentation for OCD.
To assess the scientific validity and generalizability of studies supporting memantine's efficacy in OCD treatment.

Main Methods:

Systematic review and meta-analysis of randomized controlled trials (RCTs) investigating memantine augmentation in OCD.
Critical examination of the internal and external validity of the included RCTs and the meta-analysis methodology.

Main Results:

The meta-analysis reported a high response rate (81%) for memantine augmentation versus placebo (19%) in OCD patients.
Significant differences were observed on the Yale-Brown Obsessive Compulsive Scale favoring memantine.
All four RCTs originated from the same geographical area, limiting generalizability; completer analyses compromised scientific validity.

Conclusions:

Compromised internal and external validity of the included studies undermines the meta-analysis findings.
Despite reported benefits, the routine use of memantine as an augmentation agent for OCD is not currently recommended.