[Show abstract][Hide abstract] ABSTRACT: The antiglutamatergic drug riluzole (Rilutek) is presently being used off label in the treatment of psychiatric conditions in adult patients and, increasingly, in children. This article briefly reviews the pharmacology of this drug and its current investigative and clinical uses and adverse effects. It also reports on our experience to date in the study of the drug in children, with emphasis on adverse effects noted so far in these younger patients.
Journal of child and adolescent psychopharmacology 08/2010; 20(4):309-15. DOI:10.1089/cap.2010.0009 · 2.93 Impact Factor
"Third, mouse models have indicated alterations in regional glutamate activity that correlate with behavior analogous to obsessivecompulsive symptoms (Nordstrom & Burton, 2002; Welch et al. 2007). Finally, the application of novel glutamate modulating agents, such as riluzole, has shown promise in alleviating OCD symptoms in a case report (Coric et al. 2003) and open label trials in adults (Coric et al. 2005) and children (Grant et al. 2007). Therefore, converging lines of evidence from neuroimaging, genetics, animal models and clinical trials suggest that a glutamatergic abnormality may play a critical role in the pathogenesis of OCD. "
[Show abstract][Hide abstract] ABSTRACT: This pilot study was undertaken to determine if there was a significant association between specific glutamate system genes and regional volumes of interest implicated in the pathogenesis of obsessive-compulsive disorder (OCD). Volumetric magnetic resonance imaging (MRI) and genotyping of 7 polymorphisms in two genes, glutamate receptor, ionotropic, N-methyl-d-aspartate 2B (GRIN2B) and solute linked carrier, family 1, member 1 (SLC1A1) were conducted in 31 psychotropic-naïve pediatric OCD patients. The rs1805476 variant of GRIN2B was associated with left but not right orbital frontal cortex (OFC) (p=0.04) and right but not left anterior cingulate cortex (ACC) volume (p=0.02). The SLC1A1 rs3056 variant was associated with increased total (p=0.01), left (p=0.02) and right (p=0.02) thalamic volume. These results suggest that GRIN2B and SLC1A1 may be associated with regional volumetric alterations in OFC, ACC, and thalamus in children with OCD.
"Riluzole was used successfully to augment other pharmacotherapy in an adult patient who had failed treatment with prior regimens for his severe and refractory OCD and major depressive disorder (Coric et al. 2003). There have also been case reports of the benefit of riluzole for a patient with chronic skin-picking as well as an eating disorder (Sasso et al. 2006) and in a patient with self-injurious behavior (Pittenger et al. 2005). "
[Show abstract][Hide abstract] ABSTRACT: Obsessive-compulsive disorder (OCD) in childhood is often refractory to treatment. Riluzole, a glutamate antagonist, has theoretical support as an alternative pharmacological treatment and has demonstrated possible benefit in some open-label trials in adults with OCD.
Six subjects, ages 8-16 years, were enrolled in a 12-week open-label trial of riluzole for OCD symptoms that had resisted prior treatments. OCD symptoms and adverse effects of drug were monitored.
Four of 6 subjects had clear benefit, with reduction of more than 46% (39% overall) on Children's Yale-Brown Obsessive-Compulsive Scale, and "Much Improved" or "Very Much Improved" on the Clinical Global Impressions-Improvement scale. Two subjects had no clinically meaningful change in symptom severity by 12 weeks, but 1 subject improved thereafter. There were no adverse effects of drug sufficient to cause discontinuation or reduction of dose. All subjects elected to continue riluzole after the 12-week trial.
Riluzole may be beneficial for treatment-resistant OCD in young subjects and seems well tolerated. A placebo-controlled trial of the drug is planned.
Journal of Child and Adolescent Psychopharmacology 01/2008; 17(6):761-7. DOI:10.1089/cap.2007.0021 · 2.93 Impact Factor
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