TOPIRAMATE AUGMENTATION IN THE TREATMENT OF OCD

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Obsessive-Compulsive Disorder (OCD) is generally considered a chronic, life-long illness. The results from a number of large-scale epidemiological studies conducted in the U.S. and abroad have consistently demonstrated that OCD is a relatively common psychiatric illness (Sachdev et al., 1993). Although SRI's are effective in the treatment of OCD, they are also associated with several important limitations including a delayed onset of therapeutic efficacy (8-12 weeks of treatment to baseline) in most patients with OCD. Most studies suggest that 25-30% of patients with OCD will fail to tolerate or even partially respond to SRI therapy (The Clomipramine Collaborative Study Group, 1991). Results from recent community based investigations also provided compelling support that OCD is routinely associated with considerable morbidity. Additionally, patients with OCD are reported to have elevated rates of healthcare utilization and significant impairments in social and sexual functioning (Steketee, 1997). While not yet specifically evaluated in the treatment of OCD, previous reports suggest that topiramate may be beneficial in a variety of psychiatric illnesses including affective disorders (Calabrese et al., 2001; McElroy et al., 2000) and PTSD (Berlant et al., 2002). Moreover, results from some of these initial reports suggest that topiramate may have a rapid onset of action in these indications and that the effective dose for these conditions may be below that usually found to be effective for epilepsy treatment.