Login Register Cart 0
Generic placeholder image

Current Medicinal Chemistry

Editor-in-Chief

ISSN (Print): 0929-8673
ISSN (Online): 1875-533X

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe Translate in Chinese
Systematic Review Article

Anti-Androgen Drugs in the Treatment of Obsessive-Compulsive Disorder: A Systematic Review

Author(s): Homa Nomani, Amir Hooshang Mohammadpour*, Seyed Mohammad Hassan Moallem, Mahdi Jannati YazdanAbad, George E. Barreto and Amirhossein Sahebkar*

Volume 27, Issue 40, 2020

Page: [6825 - 6836] Pages: 12

DOI: 10.2174/0929867326666191209142209

Price: $65

Abstract

Objective: This study aimed to systematically investigate whether anti-androgens could significantly reduce Obsessive-Compulsive Disorder (OCD) symptoms compared to placebo or usual care in OCD patients.

Methods: PubMed, EMBASE, CENTRAL and International Clinical Trials Registry Platform (ICTRP) databases were searched up to October 2018 using relevant keywords. All randomized and if not available non-randomized studies conducted on a population including OCD patients who were administered with anti-androgen, which reported changes in their symptoms, were included. The studies on compulsive hypersexuality were excluded. Required data were extracted from full-text of the included articles by two independent authors. One randomized and four non-randomized trials were found.

Results: The only randomized trial showed that flutamide, an anti-androgen agent, was effective in reducing compulsion scores in male OCD patients with comorbid Tourette syndrome, compared to placebo. Three out of four non-randomized trials showed that different anti-androgens including finasteride, cyproterone acetate and triptorelin were effective in reducing OCD symptoms. The only study, which failed to show the efficacy of an anti-androgen agent, administered OCD patients with flutamide. Despite the positive results, available studies provide the evidence with low quality based on the Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach.

Conclusion: Available studies are not sufficient for a precise answer to our study question. There is still a need for further large randomized blinded clinical trials to evaluate the effectiveness of antiandrogens in OCD patients. It is recommended that gender, comorbidities and subscales of Yale- Brown Obsessive-Compulsive Score (Y-BOCS) should be considered in designing the studies and interpreting their results.

Keywords: Obsessive compulsive disorder, luteinizing hormone-releasing hormone, neurosteroid, dehydroepiandrosterone, N-methyl-D-aspartic acid, Tourette syndrome.

« Previous Next »
[1]
Goodman, W.K.; Grice, D.E.; Lapidus, K.A.; Coffey, B.J. Obsessive-compulsive disorder. Psychiatr. Clin. North Am., 2014, 37(3), 257-267.
[http://dx.doi.org/10.1016/j.psc.2014.06.004] [PMID: 25150561]
[2]
Lewin, A.B.; Park, J.M.; Jones, A.M.; Crawford, E.A.; De Nadai, A.S.; Menzel, J.; Arnold, E.B.; Murphy, T.K.; Storch, E.A. Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial. Behav. Res. Ther., 2014, 56, 30-38.
[http://dx.doi.org/10.1016/j.brat.2014.02.001] [PMID: 24657310]
[3]
Ruscio, A.M.; Stein, D.J.; Chiu, W.T.; Kessler, R.C. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol. Psychiatry, 2010, 15(1), 53-63.
[http://dx.doi.org/10.1038/mp.2008.94] [PMID: 18725912]
[4]
Pittenger, C.; Bloch, M.H.; Williams, K. Glutamate abnormalities in obsessive compulsive disorder: neurobiology, pathophysiology and treatment. Pharmacol. Ther., 2011, 132(3), 314-332.
[http://dx.doi.org/10.1016/j.pharmthera.2011.09.006] [PMID: 21963369]
[5]
Jahanbakhsh, S.P.; Manteghi, A.A.; Emami, S.A.; Mahyari, S.; Gholampour, B.; Mohammadpour, A.H.; Sahebkar, A. Evaluation of the efficacy of Withania somnifera (Ashwagandha) root extract in patients with obsessive-compulsive disorder: a randomized double-blind placebo-controlled trial. Complement. Ther. Med., 2016, 27, 25-29.
[http://dx.doi.org/10.1016/j.ctim.2016.03.018] [PMID: 27515872]
[6]
Hofmeijer-Sevink, M.K.; van Oppen, P.; van Megen, H.J.; Batelaan, N.M.; Cath, D.C.; van der Wee, N.J.A.; van den Hout, M.A.; van Balkom, A.J. Clinical relevance of comorbidity in obsessive compulsive disorder: the Netherlands OCD Association study. J. Affect. Disord., 2013, 150(3), 847-854.
[http://dx.doi.org/10.1016/j.jad.2013.03.014] [PMID: 23597943]
[7]
McDougle, C.J.; Goodman, W.K.; Leckman, J.F.; Price, L.H. The psychopharmacology of obsessive compulsive disorder. Implications for treatment and pathogenesis. Psychiatr. Clin. North Am., 1993, 16(4), 749-766.
[http://dx.doi.org/10.1016/S0193-953X(18)30148-5] [PMID: 8309811]
[8]
Reddy, D.S. Neurosteroids: endogenous role in the human brain and therapeutic potentials. Prog. Brain Res; , 2010, 186, pp. 113-137.
[http://dx.doi.org/10.1016/b978-0-444-53630-3.00008-7] [PMID: 21094889]
[9]
Umathe, S.N.; Vaghasiya, J.M.; Jain, N.S.; Dixit, P.V. Neurosteroids modulate compulsive and persistent behavior in rodents: implications for obsessive-compulsive disorder. Prog. Neuropsychopharmacol. Biol. Psychiatry, 2009, 33(7), 1161-1166.
[http://dx.doi.org/10.1016/j.pnpbp.2009.06.013] [PMID: 19549549]
[10]
Gaikwad, U.; Parle, M.; Kumar, A.; Gaikwad, D. Effect of ritanserin and leuprolide alone and combined on marble-burying behavior of mice. Acta Pol. Pharm., 2010, 67(5), 523-527.
[PMID: 20873421]
[11]
Uday, G.; Pravinkumar, B.; Manish, W.; Sudhir, U. LHRH antagonist attenuates the effect of fluoxetine on marble-burying behavior in mice. Eur. J. Pharmacol., 2007, 563(1-3), 155-159.
[http://dx.doi.org/10.1016/j.ejphar.2007.02.016] [PMID: 17368614]
[12]
Lieberman, R. Androgen deprivation therapy for prostate cancer chemoprevention: current status and future directions for agent development. Urology, 2001, 58(2)(Suppl. 1), 83-90.
[http://dx.doi.org/10.1016/S0090-4295(01)01247-X] [PMID: 11502457]
[13]
Anderson, J. The role of antiandrogen monotherapy in the treatment of prostate cancer. BJU Int., 2003, 91(5), 455-461.
[http://dx.doi.org/10.1046/j.1464-410X.2003.04026.x] [PMID: 12603397]
[14]
Peterson, B.S.; Zhang, H.; Anderson, G.M.; Leckman, J.F. A double-blind, placebo-controlled, crossover trial of an antiandrogen in the treatment of Tourette’s syndrome. J. Clin. Psychopharmacol., 1998, 18(4), 324-331.
[http://dx.doi.org/10.1097/00004714-199808000-00013] [PMID: 9690699]
[15]
Bini, V.; Frau, R.; Collu, M.; Paba, S.; Devoto, P.; Marrosu, F.; Bortolato, M. Blockade of 5-alpha reductase reduces compulsive behaviors in mice. Eur. Neuropsychopharmacol., 2009, 19, S296-S297.
[http://dx.doi.org/10.1016/S0924-977X(09)70439-0]
[16]
Kudryashov, N.V.; Kalinina, T.S.; Kasabov, K.A.; Shimshirt, A.A.; Volkova, A.V.; Zhmurenko, L.A.; Voronina, T.A. The role of neurosteroids metabolism in anticompulsive effect of pyrazole[c]pyridine derivative gizh-72. Eksperimental’naya i Klinicheskaya Farmakologiya, 2018, 81(12), 7-11.
[http://dx.doi.org/10.30906/0869-2092-2018-81-2-7-11]]
[17]
Eriksson, T. Anti-androgenic treatment of obsessive-compulsive disorder: an open-label clinical trial of the long-acting gonadotropin-releasing hormone analogue triptorelin. Int. Clin. Psychopharmacol., 2007, 22(1), 57-61.
[http://dx.doi.org/10.1097/01.yic.0000224793.51900.cb]] [PMID: 17159461]
[18]
Kudryashov, N.V.; Kalinina, T.S.; Zhmurenko, L.A.; Voronina, T.A. Anticompulsive activity of a new pyrazolo[C]pyridine derivative GIZh-72 under conditions of unpredictable chronic mild stress. Bull. Exp. Biol. Med., 2016, 161(3), 377-380.
[http://dx.doi.org/10.1007/s10517-016-3418-y] [PMID: 27502699]
[19]
Casas, M.; Alvarez, E.; Duro, P.; Garcia-Ribera, C.; Udina, C.; Velat, A.; Abella, D.; Rodriguez-Espinosa, J.; Salva, P.; Jané, F. Antiandrogenic treatment of obsessive-compulsive neurosis. Acta Psychiatr. Scand., 1986, 73(2), 221-222.
[http://dx.doi.org/10.1111/j.1600-0447.1986.tb10591.x] [PMID: 2939692]
[20]
Altemus, M.; Greenberg, B.D.; Keuler, D.; Jacobson, K.R.; Murphy, D.L. Open trial of flutamide for treatment of obsessive-compulsive disorder. J. Clin. Psychiatry, 1999, 60(7), 442-445.
[http://dx.doi.org/10.4088/JCP.v60n0704] [PMID: 10453797]
[21]
Muroni, A.; Paba, S.; Puligheddu, M.; Marrosu, F.; Bortolato, M. A preliminary study of finasteride in Tourette syndrome. Mov. Disord., 2011, 26(11), 2146-2147.
[http://dx.doi.org/10.1002/mds.23810] [PMID: 21618612]
[22]
Feldman, J.D.; Noshirvani, H.; Chu, C. Improvement in female patients with severe obsessions and/or compulsions treated with cyproterone acetate. Acta Psychiatr. Scand., 1988, 78(2), 254.
[http://dx.doi.org/10.1111/j.1600-0447.1988.tb06333.x] [PMID: 2975912]
[23]
Eriksson, T. Antiandrogenic treatment for obsessive-compulsive disorder. Am. J. Psychiatry, 2000, 157(3), 483-483.
[http://dx.doi.org/10.1176/appi.ajp.157.3.483] [PMID: 10698847]
[24]
Chouinard, G.; Bélanger, M.C.; Beauclair, L.; Sultan, S.; Murphy, B.E.P. Potentiation of fluoxetine by aminoglutethimide, an adrenal steroid suppressant, in obsessive-compulsive disorder resistant to SSRIs: a case report. Prog. Neuropsychopharmacol. Biol. Psychiatry, 1996, 20(6), 1067-1079.
[http://dx.doi.org/10.1016/0278-5846(96)00084-X] [PMID: 8888111]
[25]
Bortolato, M.; Muroni, A.; Marrosu, F. Treatment of Tourette’s syndrome with finasteride. Am. J. Psychiatry, 2007, 164(12), 1914-1915.
[http://dx.doi.org/10.1176/appi.ajp.2007.07060978] [PMID: 18056252]
[26]
Erbay, L.G.; Kartalci, S. Neurosteroid levels in patients with obsessive-compulsive disorder. Psychiatry Investig., 2015, 12(4), 538-544.
[http://dx.doi.org/10.4306/pi.2015.12.4.538] [PMID: 26508966]
[27]
Bigos, K.L.; Folan, M.M.; Jones, M.R.; Haas, G.L.; Kroboth, F.J.; Kroboth, P.D. Dysregulation of neurosteroids in obsessive compulsive disorder. J. Psychiatr. Res., 2009, 43(4), 442-445.
[http://dx.doi.org/10.1016/j.jpsychires.2008.04.007] [PMID: 18514738]
[28]
Lange, K.W.; Lange, K.M.; Hauser, J.; Tucha, L.; Tucha, O. Circadian rhythms in obsessive-compulsive disorder. J. Neural Transm. (Vienna), 2012, 119(10), 1077-1083.
[http://dx.doi.org/10.1007/s00702-012-0805-z]] [PMID: 22543530]
[29]
Bini, V.; Frau, R.; Collu, M.; Paba, S.; Devoto, P.; Marrosu, F.; Bortolato, M.P. 1. d. 017 Blockade of 5-alpha reductase reduces compulsive behaviors in mice. Eur. Neuropsychopharmacol., 2009, 19, S296-S297.
[http://dx.doi.org/10.1016/S0924-977X(09)70439-0]
[30]
de la Torre, B.; Norén, S.; Hedman, M.; Diczfalusy, E. Effect of cyproterone acetate (CPA) on gonadal and adrenal function in men. Contraception, 1979, 20(4), 377-396.
[http://dx.doi.org/10.1016/S0010-7824(79)80048-7] [PMID: 228907]
[31]
Geller, J.; Albert, J.; Nachtsheim, D.A.; Loza, D.; Geller, S. The effects of flutamide on total DHT and nuclear DHT levels in the human prostate. Prostate, 1981, 2(3), 309-314.
[http://dx.doi.org/10.1002/pros.2990020309] [PMID: 6170970]

Rights & Permissions Print Cite
Article Metrics
67
World Chagas Disease
© 2024 Bentham Science Publishers | Privacy Policy