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5-Hydroxytryptophan As Adjuvant Therapy in Treatment of Moderate to Severe Obsessive-Compulsive Disorder: A Double-Blind Randomized Trial With Placebo Control Publisher Pubmed



Yousefzadeh F1 ; Sahebolzamani E1 ; Sadri A1 ; Mortezaei A1 ; Aqamolaei A1 ; Mortazavi SH1 ; Shalbafan MR2 ; Ghaffari S3 ; Alikhani R4 ; Mousavi SB4 ; Naderi S1 ; Shamabadi A1 ; Jalilevand S1 ; Akhondzadeh S1
Authors
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Authors Affiliations
  1. 1. Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran, 13337, Iran
  2. 2. Mental Health Research Center, Iran University of Medical Sciences, Iran
  3. 3. School of Persian Medicine, Iran University of Medical Sciences, Research Institute for Islamic and Complementory Medicine, Iran
  4. 4. Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

Source: International Clinical Psychopharmacology Published:2020


Abstract

On the basis of numerous previous studies, the serotonergic system plays a role in the pathogenesis of obsessive-compulsive disorder (OCD) and effective agents in this pathway, such as 5-hydroxytryptophan, can potentially contribute to treatment of patients with this disorder. Evaluating the efficacy of 5-hydroxytryptophan in treating OCD was the aim of the present randomized, double-blind, placebo-controlled 12-week trial. In a 12-week, randomized double-blind study, 60 patients with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of moderate to severe OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of >21 were randomly assigned to receive either fluoxetine plus placebo or fluoxetine plus 5-hydroxytryptophan (100 mg twice daily). All patients, regardless of their treatment group, received fluoxetine at 20 mg/day for the initial 4 weeks of the study followed by 60 mg/day of fluoxetine for the rest of the trial course. Symptoms were assessed using the Y-BOCS at baseline and weeks 4, 8 and 12. General linear model repeated measure showed significant effects for time × treatment interaction on total Y-BOCS (F = 12.07, df = 2.29, P-value <0.001), obsession (F = 8.25, df = 1.91, P-value = 0.001) and compulsion subscale scores (F = 6.64, df = 2.01, P-value = 0.002). 5-Hydroxytryptophan augmentation therapy demonstrated higher partial and complete treatment response rate (P = 0.032 and P = 0.001, respectively) according to the Y-BOCS total scores. The results of this study confirm that 5-hydroxytryptophan may be effective as an augmentative agent in treatment of moderate-to-severe OCD. © 2020 Lippincott Williams and Wilkins. All rights reserved.
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