Glutamatergic Medications for Obsessive-Compulsive and Related Disorders: A Systematic Review and Meta-Analysis
2025

Glutamatergic Medications for Obsessive-Compulsive and Related Disorders

Sample size: 1369 publication Evidence: low

Author Information

Author(s): Coelho David R. A. MD MPH, Yang Chen PhD MPH, Suriaga Armiel PhD MPH, Manasa Justen PhD MPH, Bain Paul A. PhD, Vieira Willians Fernando PhD, Papatheodorou Stefania MD PhD, Salvi Joshua D. MD PhD

Primary Institution: Harvard T.H. Chan School of Public Health

Hypothesis

Are glutamatergic medications associated with improvement in symptoms of obsessive-compulsive and related disorders (OCRDs)?

Conclusion

Glutamatergic medications may be effective in treating OCRDs, particularly OCD, but high heterogeneity and potential publication bias necessitate cautious interpretation.

Supporting Evidence

  • In this systematic review and meta-analysis of 27 randomized clinical trials involving 1369 individuals, glutamatergic medications were associated with significant improvement in symptoms of OCRDs.
  • For obsessive-compulsive disorder (OCD) specifically, these medications were associated with a significant mean reduction in Yale-Brown Obsessive Compulsive Scale scores.
  • Glutamatergic medications showed a large effect size in improving OCRD symptoms (Cohen d = −0.80).
  • Subgroup analyses indicated no significant differences in the effect size of glutamatergic medications on OCRD symptoms by type of OCRD or population.

Takeaway

This study found that certain medications that affect glutamate in the brain can help people with obsessive-compulsive disorder feel better.

Methodology

This systematic review and meta-analysis included 27 randomized clinical trials comparing glutamatergic medications with placebo for patients with OCRDs.

Potential Biases

Most studies had a low risk of bias, but some had concerns regarding the randomization process and missing outcome data.

Limitations

The study had relatively small sample sizes and excluded non-English studies, limiting the generalizability of the findings.

Participant Demographics

The mean age of participants was 31.5 years, with 65.6% female.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI, −1.13 to −0.47

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1001/jamanetworkopen.2024.52963

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