Naltrexone in Obsessive-Compulsive Disorder: An Open- Label Trial

High rates of co-morbidity of ocd with bipolar spectrum disorders are increasingly recognized.mood switching and development of rapid cycling with antidepressants are significant problems in thesepatients. from this viewpoint, introducing a non-antidepressant anti-ocd drug has great theoretical and clinicalimportance. in this open-label clinical trial we evaluated the effects of naltrexone on ocd symptoms.methods: in this study, 23 ocd outpatients treated with a fixed dose of clomipramie, fluoxetine, or both, forat least 3 months before trial underwent treatment with naltrexone, 25 to 100 milligrams a day as adjunctivetreatment. change in symptoms was evaluated by yale-brown obsessive-compulsive scale (ybocs), persianversion, administered at baseline and at the end of the 2 months trial.results: seven patients dropped out of the study before the end of the 2 months. sixteen patients, 9 femalesand 7 males, completed the study. the most frequent co-morbid disorders found in these patients were bipolarspectrum disorders (68.7%). non-parametric (wilcoxon signed ranks test) and parametric (paired t-test)analyses both showed significant reductions in ybocs ratings after naltrexone treatment (p<0.001). twopatients remained symptom free over 6 months after discontinuation of all medications.conclusion: although small sample size and open design of the trial make the results tentative, it appearsthat naltrexone may be effective on at least certain subgroups of ocd patients, especially those with both ocdand bipolar spectrum disorders. long-term effects of the drug after discontinuation should be addressed in futuredouble-blind studies.iranian journal of psychiatry and behavioral sciences (ijpbs), volume 1, number 1, spring and summer 2007: 16-21.