TY - JOUR
T1 - Anti-androgen drugs in the treatment of obsessive-compulsive disorder
T2 - A systematic review
AU - Nomani, Homa
AU - Mohammadpour, Amir Hooshang
AU - Moallem, Seyed Mohammad Hassan
AU - Yazdanabad, Mahdi Jannati
AU - Barreto, George E.
AU - Sahebkar, Amirhossein
N1 - Publisher Copyright:
© 2020 Bentham Science Publishers.
PY - 2020
Y1 - 2020
N2 - Objective: This study aimed to systematically investigate whether anti-androgens could significantly reduce Obsessive-Compulsive Disorder (OCD) symptoms compared to placebo or usual care in OCD patients. Methods: PubMed, EMBASE, CENTRAL and International Clinical Trials Registry Platform (ICTRP) databases were searched up to October 2018 using relevant keywords. All randomized and if not available non-randomized studies conducted on a population including OCD patients who were administered with anti-androgen, which reported changes in their symptoms, were included. The studies on compulsive hypersexuality were excluded. Required data were extracted from full-text of the included articles by two independent authors. One randomized and four non-randomized trials were found. Results: The only randomized trial showed that flutamide, an anti-androgen agent, was effective in reducing compulsion scores in male OCD patients with comorbid Tourette syndrome, compared to placebo. Three out of four non-randomized trials showed that different anti-androgens including finasteride, cyproterone acetate and triptorelin were effective in reducing OCD symptoms. The only study, which failed to show the efficacy of an anti-androgen agent, administered OCD patients with flutamide. Despite the positive results, available studies provide the evidence with low quality based on the Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach. Conclusion: Available studies are not sufficient for a precise answer to our study question. There is still a need for further large randomized blinded clinical trials to evaluate the effectiveness of anti-androgens in OCD patients. It is recommended that gender, comorbidities and subscales of Yale-Brown Obsessive-Compulsive Score (Y-BOCS) should be considered in designing the studies and interpreting their results.
AB - Objective: This study aimed to systematically investigate whether anti-androgens could significantly reduce Obsessive-Compulsive Disorder (OCD) symptoms compared to placebo or usual care in OCD patients. Methods: PubMed, EMBASE, CENTRAL and International Clinical Trials Registry Platform (ICTRP) databases were searched up to October 2018 using relevant keywords. All randomized and if not available non-randomized studies conducted on a population including OCD patients who were administered with anti-androgen, which reported changes in their symptoms, were included. The studies on compulsive hypersexuality were excluded. Required data were extracted from full-text of the included articles by two independent authors. One randomized and four non-randomized trials were found. Results: The only randomized trial showed that flutamide, an anti-androgen agent, was effective in reducing compulsion scores in male OCD patients with comorbid Tourette syndrome, compared to placebo. Three out of four non-randomized trials showed that different anti-androgens including finasteride, cyproterone acetate and triptorelin were effective in reducing OCD symptoms. The only study, which failed to show the efficacy of an anti-androgen agent, administered OCD patients with flutamide. Despite the positive results, available studies provide the evidence with low quality based on the Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach. Conclusion: Available studies are not sufficient for a precise answer to our study question. There is still a need for further large randomized blinded clinical trials to evaluate the effectiveness of anti-androgens in OCD patients. It is recommended that gender, comorbidities and subscales of Yale-Brown Obsessive-Compulsive Score (Y-BOCS) should be considered in designing the studies and interpreting their results.
KW - Dehydroepian-drosterone
KW - Luteinizing hormone-releasing hormone
KW - N-methyl-D-aspartic acid
KW - Neurosteroid
KW - Obsessive compulsive disorder
KW - Tourette syndrome
UR - http://www.scopus.com/inward/record.url?scp=85095847485&partnerID=8YFLogxK
U2 - 10.2174/0929867326666191209142209
DO - 10.2174/0929867326666191209142209
M3 - Review article
C2 - 31814547
AN - SCOPUS:85095847485
SN - 0929-8673
VL - 27
SP - 6825
EP - 6836
JO - Current Medicinal Chemistry
JF - Current Medicinal Chemistry
IS - 40
ER -