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Review: Investigational and Experimental Drugs to Treat Obsessive-Compulsive Disorder

Investigational and Experimental Drugs to Treat Obsessive-Compulsive Disorder

Grassi G, Cecchelli C, Vignozzi L, Pacini S. Investigational and Experimental Drugs to Treat Obsessive-Compulsive Disorder. J Exp Pharmacol. 2021;12:695-706. Published 2021 Jan 5. doi:10.2147/JEP.S255375

“Treatment-resistance is a frequent condition for obsessive-compulsive disorder (OCD). Over the past decades, a lot of effort has been made to address this issue, and several augmentation strategies of serotonergic drugs have been investigated. Antidopaminergic drugs are considered the first choice as augmentation strategy for treatment-resistant OCD patients, but they seem to work only for a subset of patients, and none of them have been officially approved for OCD. Recently, the role of glutamate and inflammation in OCD pathophysiology clearly emerged, and this has led to several investigations on glutamatergic and anti-inflammatory agents. Results seem promising but still inconclusive. Probiotic interventions (considered to modulate the immune systems and the brain activity) are gaining attention in several psychiatric fields but are still at their early stages in the OCD field. Research on new treatment approaches for OCD is moving forward, and more than one hundred interventional trials are ongoing around the world. While the vast majority of these trials involve neuromodulation and psychotherapeutic approaches, only a small proportion (around 20%) involve the investigation of new pharmacological approaches (tolcapone, nabilone, psilocybin, troriluzole, nitrous oxide, rituximab, naproxen, and immunoglobulins). Here, we provide a comprehensive review of investigational and experimental drugs to treat OCD.”

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Genes, Cells, and Neural Circuits Relevant to OCD and Autism Spectrum Disorder

Editor’s Note:
Genes, Cells, and Neural Circuits Relevant to OCD and Autism Spectrum Disorder
Ned H. Kalin, M.D.
Published Online:1 Jan 2021 DOI 10.1176/appi.ajp.2020.20111605

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“These cross-species translational data are potentially exciting and serve to focus the search for the pathophysiology of PANDAS toward a specific class of inter-neurons within the striatum that are known to fine tune and regulate striatal output via their influences on the abundant medium spiny GABAergic neurons that project to effector sites. Because of the similarities between PANDAS and bonafide OCD, these studies raise the possibility that striatal cholinergic interneurons are mechanistically involved in the pathophysiology of childhood OCD. In his editorial (9), Dr. Steve Hyman from Harvard University critically appraises this study and suggests that, in addition to the mechanism suggested by the findings in this article, other immune-related molecular pathways may also be important.”

Catatonia in a 6-year-old Patient Following Disseminated Group A Streptococcus Infection
Cawkwell PB, Mayor ID, Shaw RJ. Catatonia in a 6-year-old Patient Following Disseminated Group A Streptococcus Infection. Innov Clin Neurosci. 2021 Jan 1;18(1-3):17-20. PMID: 34150358; PMCID: PMC8195556.
  • Catatonia is a neuropsychiatric syndrome characterized by diverse features including mutism, posturing, negativism, staring, rigidity, and echophenomenon.
  • The mechanism of catatonia is still being elucidated; in this case, catatonia triggered by GAS infection is one potential mechanism.
  • Further systematic study of catatonia in the pediatric population is warranted to better understand pathogenesis and long-term neuropsychiatric outcomes.
Predictors and Prospective Course of PANS: A Pilot Study Using Electronic Platforms for Data Collection

Predictors and Prospective Course of PANS: A Pilot Study Using Electronic Platforms for Data Collection

Conclusion: Our study highlights the utility of electronic methods for tracking longitudinal symptoms in children with PANS and suggests that particular baseline characteristics (e.g., delay in identification and treatment of PANS, greater caregiver burden) may be indicative of a differential trajectory of PANS course, with more severe symptoms over the short term. clinicaltrials.gov NCT04382716.

Elizabeth C. Harris, Christine A. Conelea, Michael T. Shyne, and Gail A. Bernstein.Journal of Child and Adolescent Psychopharmacology. http://doi.org/10.1089/cap.2020.0124
2020 Year in Review
December 28, 2020
2020 Year in Review

Despite the challenges of 2020, we are proud to report that the ASPIRE community continues to grow in size, support, and strength. We are grateful to all of you for your contributions: the...

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Prevalence of PANS in Child Prevalence of pediatric acute-onset neuropsychiatric syndrome (PANS) in children and adolescents with eating disorders Adolescent Eating Disorders
Prevalence of PANS in Child and Adolescent Eating Disorders
Marya Aman, Jennifer Coelho, BoyeeLin, Cynthia Lu, Shannon Zaitsoff, John Best and S. Evelyn StewartBC Children’s Hospital Research Institute, University of British Columbia
“Conclusion
  •  The surprisingly high lifetime PANS rate of 52% within pediatric ED were higher than that previously reported for OCD populations. The large majority had abrupt onset of parent- reported OC symptoms as well as abrupt food restriction.
  • Those in the PANS group were more likely to be female, be prescribed an SSRI, and have parent reported abrupt OC symptom onset, abrupt food refusal, relapsing and remitting course, and concurrent anxiety, depression, irritability or aggression, behavioural regression, school deterioration, and sleep problems, enuresis, and/or frequent urination.
  • This appears to be a distinct subgroup that requires further characterization with respect to functional impacts and management approaches.”