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Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials

Obsessive–compulsive disorder (OCD) is the fourth most common mental disorder, and selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of its pharmacological treatment. About 40–60% of the cases are treatment-refractory, and this makes searching for second-line treatment necessary. 5...

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Autores principales: Eissazade, Negin, Mosavari, Hesam, Eghdami, Shayan, Boroon, Mahsa, Ashrafi, Faria, Shalbafan, Mohammadreza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682036/
https://www.ncbi.nlm.nih.gov/pubmed/38012263
http://dx.doi.org/10.1038/s41598-023-47931-x
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author Eissazade, Negin
Mosavari, Hesam
Eghdami, Shayan
Boroon, Mahsa
Ashrafi, Faria
Shalbafan, Mohammadreza
author_facet Eissazade, Negin
Mosavari, Hesam
Eghdami, Shayan
Boroon, Mahsa
Ashrafi, Faria
Shalbafan, Mohammadreza
author_sort Eissazade, Negin
collection PubMed
description Obsessive–compulsive disorder (OCD) is the fourth most common mental disorder, and selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of its pharmacological treatment. About 40–60% of the cases are treatment-refractory, and this makes searching for second-line treatment necessary. 5-Hydroxytryptamine-3 (5-HT3) antagonists are among the many medications that have been used in augmentation with SSRIs. In this systematic review and meta-analysis, we assessed the efficacy and safety of 5-HT3 receptor antagonists in augmentation with SSRIs in treating moderate to severe OCD. We searched PubMed, Web of Science, Scopus, Cochrane library, and Google Scholar for relevant trials published up to December 2022. The effect size was the mean difference in Yale-Brown obsessive compulsive scale (Y-BOCS) scores before and after receiving 5-HT3 receptor antagonist drugs in augmentation with SSRIs in moderate to severe OCD patients. We included 6 randomized-controlled trails (RCTs) with 334 patients assessing the effect of the augmentation of SSRIs with ondansetron, granisetron, and tropisetron on treating moderate to severe OCD. Our results were in favor of the experimental group in total (Z = 8.37, P < 0.00001), in the compulsion subgroup (Z = 5.22, P < 0.00001), and in the obsession subgroup (Z = 8.33, P < 0.00001). They are well-tolerated, and have mild side effects and do not result in withdrawal. Augmentation of 5-HT3 antagonists with SSRIs can be beneficial in treating moderate to severe OCD. Further multi-center trials under adequate conditions in longer periods are needed to help come up with a comprehensive action plan.
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spelling pubmed-106820362023-11-30 Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials Eissazade, Negin Mosavari, Hesam Eghdami, Shayan Boroon, Mahsa Ashrafi, Faria Shalbafan, Mohammadreza Sci Rep Article Obsessive–compulsive disorder (OCD) is the fourth most common mental disorder, and selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of its pharmacological treatment. About 40–60% of the cases are treatment-refractory, and this makes searching for second-line treatment necessary. 5-Hydroxytryptamine-3 (5-HT3) antagonists are among the many medications that have been used in augmentation with SSRIs. In this systematic review and meta-analysis, we assessed the efficacy and safety of 5-HT3 receptor antagonists in augmentation with SSRIs in treating moderate to severe OCD. We searched PubMed, Web of Science, Scopus, Cochrane library, and Google Scholar for relevant trials published up to December 2022. The effect size was the mean difference in Yale-Brown obsessive compulsive scale (Y-BOCS) scores before and after receiving 5-HT3 receptor antagonist drugs in augmentation with SSRIs in moderate to severe OCD patients. We included 6 randomized-controlled trails (RCTs) with 334 patients assessing the effect of the augmentation of SSRIs with ondansetron, granisetron, and tropisetron on treating moderate to severe OCD. Our results were in favor of the experimental group in total (Z = 8.37, P < 0.00001), in the compulsion subgroup (Z = 5.22, P < 0.00001), and in the obsession subgroup (Z = 8.33, P < 0.00001). They are well-tolerated, and have mild side effects and do not result in withdrawal. Augmentation of 5-HT3 antagonists with SSRIs can be beneficial in treating moderate to severe OCD. Further multi-center trials under adequate conditions in longer periods are needed to help come up with a comprehensive action plan. Nature Publishing Group UK 2023-11-27 /pmc/articles/PMC10682036/ /pubmed/38012263 http://dx.doi.org/10.1038/s41598-023-47931-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Eissazade, Negin
Mosavari, Hesam
Eghdami, Shayan
Boroon, Mahsa
Ashrafi, Faria
Shalbafan, Mohammadreza
Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials
title Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials
title_full Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials
title_fullStr Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials
title_full_unstemmed Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials
title_short Efficacy and safety of 5-hydroxytryptamine-3 (5-HT3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (SSRIs) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials
title_sort efficacy and safety of 5-hydroxytryptamine-3 (5-ht3) receptor antagonists in augmentation with selective serotonin reuptake inhibitors (ssris) in the treatment of moderate to severe obsessive–compulsive disorder: a systematic review and meta-analysis of randomized clinical trials
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10682036/
https://www.ncbi.nlm.nih.gov/pubmed/38012263
http://dx.doi.org/10.1038/s41598-023-47931-x
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