Treatment of refractory obsessive-compulsive disorder with nutraceuticals (TRON): a 20-week, open label pilot study

Jerome Sarris, Gerard J. Byrne, Georgina Oliver, Lachlan Cribb, Scott Blair-West, David Castle, Olivia M. Dean, David A. Camfield, Vlasios Brakoulias, Chad Bousman, Nathan Dowling, Carolyn Ee, Jenifer Murphy, Ranjit Menon, Michael Berk, Suneel Chamoli, Mark Boschen, Chee H. Ng

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)

Abstract

Background Obsessive-compulsive disorder (OCD) is often challenging to treat and resistant to psychological interventions and prescribed medications. The adjunctive use of nutraceuticals with potential neuromodulatory effects on underpinning pathways such as the glutamatergic and serotonergic systems is one novel approach. Objective To assess the effectiveness and safety of a purpose-formulated combination of nutraceuticals in treating OCD: N-acetyl cysteine, L-theanine, zinc, magnesium, pyridoxal-5′ phosphate, and selenium. Methods A 20-week open label proof-of-concept study was undertaken involving 28 participants with treatment-resistant DSM-5-diagnosed OCD, during 2017 to 2020. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Scale (YBOCS), administered every 4 weeks. Results An intention-to-treat analysis revealed an estimated mean reduction across time (baseline to week-20) on the YBOCS total score of -7.13 (95% confidence interval = -9.24, -5.01), with a mean reduction of -1.21 points per post-baseline visit (P ≤.001). At 20-weeks, 23% of the participants were considered responders (YBOCS ≥35% reduction and very much or much improved on the Clinical Global Impression-Improvement scale). Statistically significant improvements were also revealed on all secondary outcomes (eg, mood, anxiety, and quality of life). Notably, treatment response on OCD outcome scales (eg, YBOCS) was greatest in those with lower baseline symptom levels, while response was limited in those with relatively more severe OCD. Conclusions While this pilot study lacks placebo-control, the significant time effect in this treatment-resistant OCD population is encouraging and suggests potential utility especially for those with lower symptom levels. Our findings need to be confirmed or refuted via a follow-up placebo-controlled study.

Original languageEnglish
Pages (from-to)588-597
Number of pages10
JournalCNS SPECTRUMS
Volume27
Issue number5
DOIs
Publication statusPublished - 2022
Externally publishedYes

Keywords

  • N-acetyl cysteine
  • nutrients
  • OCD
  • treatment-resistant
  • vitamins
  • zinc

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