Naltrexone in Obsessive-Compulsive Disorder: an Open- Label Trial

Aram Hamidi; Bijan Jahanguiri; Mehdi Nasr Nasr Esfahanini; Mahbuobeh Dadfar

IJ Psychiatry and Behavioral Sciences

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Naltrexone in Obsessive-Compulsive Disorder: an Open- Label Trial

Author(s):

Aram Hamidi^1,*,

Bijan Jahanguiri²,

Mehdi Nasr Nasr Esfahanini³,

Mahbuobeh Dadfar³

1Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran, +98-2177537842

2Department of Pharmacology, Tehran University of Medical sciences, Tehran, Iran

3Tehran Psychiatric Institute, Iran University of Medical sciences, Tehran, Iran

IJ Psychiatry and Behavioral Sciences:Vol. 1, issue 1; 16-21

Published online:Jan 30, 2007

Article type:Research Article

Received:Oct 30, 2006

Accepted:Dec 04, 2006

How to Cite:Aram HamidiBijan JahanguiriMehdi Nasr Nasr EsfahaniniMahbuobeh DadfarNaltrexone in Obsessive-Compulsive Disorder: an Open- Label Trial.Iran J Psychiatry Behav Sci.1(1):16-21.

Abstract

Objective: In spite of introduction of novel drugs, Obsessive-Compulsive Disorder (OCD) has still found no suitable treatment. On the other hand, high rates of co-morbidity of OCD with bipolar spectrum disorders are increasingly recognized. Mood switching and development of rapid cycling with antidepressants are significant problems in these patients. From this viewpoint, introducing a non-antidepressant anti-OCD drug has great theoretical and clinical importance. In this open-label clinical trial we evaluated the effects of naltrexone on OCD symptoms

Method: In this study, 23 OCD outpatients treated with a fixed dose of clomipramie, fluoxetine, or both, for at least 3 months before trial underwent treatment with naltrexone, 25 to 100 milligrams a day as adjunctive treatment. Change in symptoms was evaluated by Yale-Brown Obsessive-Compulsive Scale (YBOCS), Persian version, administered at baseline and at the end of the 2 months trial.

Results: Seven patients dropped out of the study before the end of the 2 months: 4 patients for non-response and 3 patients for intolerable side effects. Sixteen patients, 9 females and 7 males, completed the study. The most frequent co-morbid disorders found in these patients were bipolar spectrum disorders (68.7%). Non-parametric (Wilcoxon Signed Ranks Test) and parametric (paired t-test) analyses both showed significant reductions in YBOCS ratings after naltrexone treatment (P<0.001). Two patients remained symptom free over 6 months after discontinuation of all medications

Conclusion: Although small sample size and open design of the trial make the results tentative, it appears that naltrexone may be effective on at least certain subgroups of OCD patients, especially those with both OCD and bipolar spectrum disorders. Long-term effects of the drug after discontinuation should be addressed in future double-blind studies.

Keywords

Bipolar Disorder

Naltrexone

Obsessive-Compulsive Disorder

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