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Protocol for a Systematic Review and Meta-Analysis of Lithium, Anticonvulsive or Atypical Antipsychotic Drugs for Treatment of Refractory Obsessive-Compulsive Disorder Pubmed



Soleimani R1 ; Jalali MM2 ; Keshtkar A3 ; Jalali SM4
Authors
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Authors Affiliations
  1. 1. Psychiatric Department, Shafa Hospital, Guilan University of Medical Sciences, Iran
  2. 2. Otolaryngology Department, Amiralmomenin Hospital, Guilan University of Medical Sciences, Iran
  3. 3. Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences, Iran
  4. 4. Pharmacy Faculty, Mashhad University of Medical Sciences, Iran

Source: Journal of medicine and life Published:2017


Abstract

INTRODUCTION: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that causes significant distress to the afflicted individual. About half of OCD patients treated with an adequate trial of serotonin reuptake inhibitors fail to fully respond to treatment and continue to exhibit significant symptoms. Therefore, there is a need for other agents to alleviate the symptoms of these disorders. In spite of considerable research including numerous randomized controlled trials and systematic reviews, there exists uncertainty regarding what treatments are effective. In this systematic review, we evaluated the efficacy of mood stabilizers in treatment-refractory OCD. MATERIALS AND METHODS: We conducted a meta-analysis of all randomized clinical trials evaluating lithium, anticonvulsive agents or atypical antipsychotic drugs for OCD to determine which therapies show more effective than a placebo, in reducing obsessive-compulsive symptoms. We acquired eligible studies through a systematic search of Cochrane Central Registry of Controlled Trials, MEDLINE, EMBASE, PsycINFO, Scopus, ProQuest and Google scholar. We conducted meta-analyses to establish the effect of lithium, anticonvulsive agents, or atypical antipsychotic drugs on patient-important outcomes when possible. To assess relative effects of treatments, we constructed a random effect model. DISCUSSIONS: Our review was the first to evaluate all treatments for OCD, to provide the relative effectiveness of lithium, anticonvulsive agents, or atypical antipsychotic drugs, and prioritize patient-important outcomes with a focus on functional gains. Our review facilitated the evidence-based management of patients with resistant OCD, and identified the key areas for future research.