OCD & NAC/ oxidative stress -- 2 reports

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N-Acetylcysteine Augmentation in the Treatment of Obsessive Compulsive

Disorder

Reference: “N-acetylcysteine augmentation in serotonin reuptake

inhibitor refractory obsessive-compulsive disorder,” Lafleur DL,

Pittenger C, et al, Psychopharmacology (Berl), 2006; 184(2): 254-6.

Summary: In a case study involving a patient with serotonin reuptake

inhibitor (SRI)-refractory obsessive-compulsive disorder (OCD),

augmentation of fluvoxamine treatment with N-acetylcysteine (NAC) over a

period of several weeks was found to significantly improve OCD symptoms.

Since NAC is thought to attenuate glutamatergic dysfunction, which has

been implicated in the pathophysiology of OCD, this study evaluated the

efficacy of fluvoxamine treatment augmented with NAC. NAC

(pharmaceutical grade, in capsule form) was initiated at 600 mg PO daily

and titrated upward to a total daily dosage of 3 g over 6 weeks. NAC was

continued at the dosage of 3 g per day for an additional 7 weeks.

Fluvoxamine 300 mg was continued throughout the NAC treatment period.

NAC augmentation of fluvoxamine resulted in a clinically significant

improvement in OCD symptoms and a marked decrease in Yale-Brown

Obsessive Compulsive Scale (Y-BBOCS). Thus, this study suggests that NAC

augmentation may be effec tive in treating SRI-refractory OCD, and

further studies to investigate the role of NAC and other glutamate

modulating agents in the treatment of OCD are warranted.

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Significant Relationship between Obsessive Compulsive Disorder and

Oxidative Stress

Reference: “Examination of free radical metabolism and antioxidant

defence system elements in patients with obsessive-compulsive disorder,”

Ersan S, Bakir S, et al, Prog Neuropsychopharmacol Biol Psychiatry, 2006

May 6 [Epub ahead of print]. (Address: Department of Chemistry

Engineering, Engineering Faculty, Cumhuriyet University, Sivas, Turkey).

Summary: In a study involving 30 patients with obsessive compulsive

disorder (OCD) who were drug-free at least for one month, and 30 healthy

age- and sex-matched controls, a significant relationship was found

between OCD and oxidative stress. Erythrocyte malondialdehyde (MDA, a

natural product of lipid peroxidation in all mammalian cells) levels and

plasma vitamin C and E concentrations were measured in both patients and

controls. MDA levels were found to be significantly higher in patients

than in controls, while plasma vitamin E levels were found to

significantly lower in patients than in controls. Although plasma

vitamin C levels were observed to be lower in patients than in controls,

the difference was not statistically significant. Additionally, a

significant correlation was found between increasing MDA levels and

decreasing vitamin E concentrations. Thus, the findings of this study

indicate that a significant relationship exists between OCD and

oxidative stress, and therefo re suggests that free radicals and the

antioxidant defense system may play a role in OCD. Further biochemical

studies are warranted to better understand OCD and its treatment.

--

ne Holden, MS, RD < fivestar@... >

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