evaluation of clonidine augmentation therapy for obsessive-compulsive disorder treatment; a randomized clinical trial

Background: obsessive-compulsive disorder (ocd) is a common neuropsychiatric disorder worldwide. inadequate response of ocd patients to a usual agent makes this disorder a great challenge, and recent studies have recommended augmentation therapy as a new choice. objectives: as traces of noradrenergic dysfunction have been noted in ocd pathophysiology, the current study aimed to assess the efficacy of clonidine augmentation therapy for treating ocd. methods: this was a randomized clinical trial conducted on 57 ocd patients divided into the two groups of 1-mg clonidine augmentation therapy (n = 28) and placebo group (n = 29). the medication was administered for 12 weeks. patients’ primary treatment, including ssris or clomipramine, continued by receiving the same dose used before participation in this study. the yale-brown obsessive-compulsive scale (y-bocs) and clinical global impression-severity scale (cgi-s) were used to assess the patients at the start of the study and then at four-week intervals. drug-related adverse effects and global improvement were assessed and compared between the two groups. results: the initial cgi scores were 3.89 ± 1.57 and 4.10 ± 1.61 at the baseline and 2.29 ± 1.18 and 3.07 ± 1.51 at the end of the study in the intervention and control groups, respectively. both groups revealed a significant improvement (p-value = 0.001) with no significant difference between them (p-value = 0.22). the primary y-bocs score in the clonidine-treated group was 27.61 ± 8.08 versus 28.69 ± 7.44 in the control group at the baseline, which declined to 20.25 ± 6.08 versus 25.45 ± 7.35 at the end of the study, respectively. both groups revealed a significant improvement (p-value = 0.001), but there was no statistically significant difference between them (p-value = 0.06). drug-related complications were not statistically different between the two groups (p-value > 0.05); however, the clonidine-treated patients presented more adverse effects than control subjects. conclusions: although the use of clonidine posed no remarkable drug-related adverse effects, it was not superior to placebo considering symptom relief.